ONE Knee and Foot Flashcards
Valgus/Varus Stress Tests
Valgus stress test
• Medial collateral ligament
• Compare bilaterally
• Supine. Legs extended
• Hand – lateral knee and medial malleolus • Medial/lateral pressure
• + pain without laxity – collateral ligament
• + pain with laxity – collateral & cruciate ligament
• Supine. Knee flexed 30
• + pain without laxity – grade 1 collateral sprain • + pain with laxity – grade 2 collateral sprain
Varus stress test
• Lateral collateral ligament
• Compare bilaterally
• Supine. Legs extended
• Hand – medial knee and lateral malleolus • Medial/lateral pressure
• + pain without laxity – collateral ligament
• + pain with laxity – collateral & cruciate ligament
• Supine. Knee flexed 30
• + pain without laxity – grade 1 collateral sprain • + pain with laxity – grade 2 collateral sprain
Drawer Sign
Drawer Sign • +5 mm of tibial movement on the femur • Injury or tear • Anterior cruciate ligament • Posterolateral capsule • Posteromedial capsule • Medial collateral ligament (more than 1cm movement) • Iliotibial band • Posterior oblique ligament • Arcuate-popliteus complex
Anterior Drawer Sign • Anterior Cruciate ligament • Procedure: Patient supine • Flex the leg and place the foot on the table • Sit or stabilize foot • Grasp behind the knee • Check Hamstring tendons must be relaxed • Pull on the leg • Compare bilaterally • +5 mm of tibial movement on the femur
Posterior Drawer Sign • Posterior cruciate ligament • Same position as Anterior Drawer Test with hands at xiyan/dubi • Push • Grade 1 injury – movement 1mm-5mm • Grade 2 injury – movement 5mm-10mm • Grade 3 injury – movement 10mm+ • Posterior cruciate ligament • Arcuate-popliteus complex • Posterior oblique ligament • Anterior cruciate ligament
Slocum Test
Usually the wrong answer
Slocum Test
• Anterior Cruciate Ligament
• Patient sits with legs handing off table
• Hand behind proximal tibia – anterior force • Hand ankle – stabilize
• Repeat internal/external rotated
• + Tibia moves anteriorly
Hughston’s Palpation of Knee Joint Line for tenderness/Mc Murray Test
Medio patellar Plica Test (synovial tissue folds) • Supine. Flex knee 30
• Push patellar lateral→medial
• While palpating medial patella
• Medial synovial plica moves between patella and patellar groove • + Pain medial knee
Anterior Drawer Test
Ankle stability,
anterior talofibular ligament is most injured ligament on foot**
- Supine
- Stabilize distal tibia anteriorly
- Grasp calcaneus
- Traction in direction of anterior talofibular ligament • + increased mobility, laxity
- Compare bilaterally
Talar Tilt
Calcaneofibular Stability
• Supine
• Grasp calcaneus. Plantar surface of foot to chest • Open calcaneofibular joint
• +increased mobility, laxity
Morton’s Test
Fibrous adhesions (scar tissue) that have built up on the medial plantar nerve due to trauma and repetitive motion.
for Morton’s Neuroma, metatarsal stress fracture
• Compress ub66→SP3
• +numbness, paresthesia
• Compress local intermetatarsal space
• + Pain on metatarsal without paresthesia – stress fracture
Apley’s compression
Mc Murray’s
Figure four,
grind knee into joint,
feel for meniscus tear
Plantar fascitis test
Windlass test
dorsiflex toes
which is worse in morning, which is worse after walking?
plantar fascitis
mortons neuroma
