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7 - CLET Lab > Orthopedic Diagnosis: Lower Extremities > Flashcards

Orthopedic Diagnosis: Lower Extremities Flashcards

1
Q

Morton Test

A
  • Positive: Sharp pain in the forefoot
    • Indicates: Metatarsalgia or neuroma (usually at the 3rd or 4th metatarsal interspace)
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2
Q

Iliac Compression Test

A
  • Positive: Pain in either sacroiliac joint
    • Indicates: Sacroiliac joint lesion
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3
Q

Apley Compression Test

A
  • Positive: Patient points to side of pain
    • Indicates: Pain on the medial side is medial meniscus tear. Pain on the lateral side indicates lateral meniscus tear
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4
Q

Femoral Nerve Traction Test

A
  • Positive: Pain on the anterior portion of the thigh
    • Indicates: Traction on the femoral nerve indicating involvement of the 2nd, 3rd and 4th lumbar nerve roots
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5
Q

Thompson Test

A
  • Positive: Absence of foot plantarflexion motion
    • Indicates: Achilles tendon rupture
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6
Q

Hibb Test

A
  1. Pain in the hip region
    • Indicates: Hip joint pathology
  2. Pain in the buttock/pelvic region
    • Sacroiliac joint lesion
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7
Q

O’Donoghue Maneuver of the Hip and Pelvis

A
  1. Hip Flexion
  2. Hip Extension
  3. Hip Abduction
  4. Hip Adduction
  5. Hip Internal Rotation
  6. Hip External Rotation
  7. Positive: Pain during passive range of motion
    • Indicates: Ligamentous sprain (passive range of motion stresses ligaments)
  8. Positive: Pain during resisted range of motion
    • Indicates: Muscle/tendon strain (active range of motion stresses muscles and tendons)
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8
Q

Bounce Home Test

A
  • Positive: Knee does not go into full extension (slight flexion remains)
    • Indicates: Diffuse swelling of the knee, accumulation of fluid due to possible torn meniscus
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9
Q

Thomas Test

A
  • Positive: Lumbar spine maintains lordosis (should flatten) and hip or leg flexes
    • Indicates: Contracture of the hip flexors (iliopsoas)
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10
Q

Ely Sign

A
  • Positive: Hip on side being tested will flex causing the buttock to raise off the table
    • Indicates: Rectus femoris or hip flexor contracture
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11
Q

Femoral Stretch Test

A
  • Positive: Pain on the anterior portion of the thigh
    • Indicates: Traction on the femoral nerve indicating involvement of the 2nd, 3rd and 4th lumbar nerve roots
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12
Q

Drawer Test

A
  1. Positive: Gapping > 6mm (tibia moves posterior) when the leg is pushed
    • Indicates: Torn posterior cruciate ligament
  2. Positive: Gapping > 6mm (tibia moves anterior) when the leg is pulled
    • Indicates: Torn anterior cruciate ligament
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13
Q

Mazion Pelvic Maneuver

A

Positive: The inability to bend at the waist more than 45°, because of either/or:

  1. Radiating pain along the sciatic nerve, either unilateral or bilateral
    • Indicates: Sciatic neuralgia or radiculopathy, etc., possibly due to lumbar disc pathology
  2. Low back pain (lumbar or pelvic regions)
    • Indicates: Anterior (rotational) displacement of the ilium relative to the sacrum
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14
Q

Medial Collateral Ligament Test

(Knee)

A
  • Positive: Gapping and/or elicited pain above/at or below joint line
    • Indicates: Tear and/or instability of the medial collateral ligament
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15
Q

Apprehension Test for the Patella

A
  • Positive: Apprehension, distress of facial expression, contraction of quadriceps to bring patella back in line
    • Indicates: Chronic patella dislocation or pre-disposition to dislocation
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16
Q

Ely Heel to Buttock Test

A
  1. Positive: Inability to raise the thigh
    • Indicates: Iliopsoas spasm
  2. Positive: Pain in the anterior thigh
    • Indicates: Inflammation of the lumbar nerve roots
  3. Positive: Pain in the lumbar region
    • Lumbar nerve root adhesions
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17
Q

Drawer Sign

A

Positive: Translation with the talus moving away from or toward the tibia

  1. With tibia pushed/foot pulled
    • Indicates: A tear/instability of the anterior talofibular ligament
  2. With tibia pulled/foot pushed
    • Indicates: A tear/instability of posterior talofibular ligament
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18
Q

Fajersztajn Test

A
  1. Positive: Pain down affected leg (Cross-Over Sign)
    • Indicates: Medial disc protrusion
  2. Positive: Decrease in pain down affected leg
    • Indicates: Lateral disc protrusion
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19
Q

Patella Ballottment Test

A
  • Positive: A floating sensation of the patella
    • Indicates: A large amount of swelling in the knee
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20
Q

Bonnet Sign

A
  • Positive: Pain in the posterior thigh or leg
    • Indicates: Immediate pain is sciatic neuropathy from piriformis syndrome
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21
Q

Laguerre Test

A
  1. Positive: Pain in the hip joint
    • Indicates: Hip joint pathology
  2. Positive: Pain in the sacroiliac joint
    • Indicates: Mechanical problem of the sacroiliac joint
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22
Q

Gaenslen Test

A
  • Positive: Pain on the affected sacroiliac joint stressed into extension
    • Indicates: General sacroiliac joint lesion, anterior sacroiliac ligament sprain, or inflammation of the sacroiliac joint
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23
Q

Trendelenburg Test

A
  • Positive: High iliac crest on supported side and low crest on side of elevated leg
    • Indicates: Weak gluteus medius muscle on the supported side
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24
Q

Lindner Sign

A
  • Positive: Pain along sciatic distribution or sharp, diffuse leg pain
    • Indicates: Sciatic radiculopathy
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25
Q

Abduction Stress Test

(Knee)

A
  • Positive: Gapping and/or elicited pain above/at or below joint line
    • Indicates: Tear and/or instability of the medial collateral ligament
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26
Q

Patella Femoral Grinding Test

A
  • Positive: Retropatellar pain and the patient is unable to hold the quadriceps contraction
    • Indicates: Degenerative changes of the patellar facets and/or within the trochlear groove (chondromalacia patella)
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27
Q

Bragard Sign

A
  • Positive: Radiating pain in posterior thigh
    • Indicates: Sciatic radiculopathy
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28
Q

Pelvic Rock Test

A
  • Positive: Pain in either sacroiliac joint
    • Indicates: Sacroiliac joint lesion
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29
Q

McMurray Sign

A
  • Positive: Clicking sound or pain by knee joint
    • Indicates: Tear of medial meniscus if positive on external rotation. Tear of the lateral meniscus on internal rotation. The higher the leg is raised during extension when positive is elicited, the more posterior the meniscal injury
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30
Q

Anterior Drawer Sign of the Ankle

A

Positive: Translation with the talus moving away from or toward the tibia

  1. With tibia pushed/foot pulled
    • Indicates: A tear/instability of the anterior talofibular ligament
  2. With tibia pulled/foot pushed
    • Indicates: A tear/instability of posterior talofibular ligament
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31
Q

SLR

A
  • Positive: Radiating pain and/or dull posterior thigh pain
    • Indicates: Sciatic radiculopathy or tight hamstrings. Positive between 35-70° = possible discogenic sciatic radiculopathy. Positive greater than 70° = tight hamstrings
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32
Q

Advancement Sign

A

Positive: The inability to bend at the waist more than 45°, because of either/or:

  1. Radiating pain along the sciatic nerve, either unilateral or bilateral
    • Indicates: Sciatic neuralgia or radiculopathy, etc., possibly due to lumbar disc pathology
  2. Low back pain (lumbar or pelvic regions)
    • Indicates: Anterior (rotational) displacement of the ilium relative to the sacrum
33
Q

Patrick Test

A
  • Positive: Pain in the hip region
    • Indicates: Hip joint pathology
34
Q

Yeoman Test

A
  • Positive: Pain deep in the sacroiliac joint
    • Indicates: Sprain of the anterior sacroiliac ligaments
35
Q

Toe Walk

A
  • Positive: Inability to perform the test
    • Indicates: L5-S1 disc lesion (L5 nerve root)
36
Q

Neri Sign

A
  • Positive: Pain accompanied by flexion of the knee on the affected side and body rotation away from the affected side
    • Indicates: Positive with a variety of low back pathoogies. Hamstring tension on the pelvis may trigger the response
37
Q

Belt Test

A
  1. Positive: Low back pain while bending with the sacrum stabilized and unstabilized
    • Indicates: Lumbar involvement
  2. Positive: Low back pain during sacrum non-stabilized bending and no pain duing sacrum stabilized bending
    • Indicates: Pelvic involvement
38
Q

Clarke Sign

A
  • Positive: Retropatellar pain and the patient is unable to hold the quadriceps contraction
    • Indicates: Degenerative changes of the patellar facets and/or within the trochlear groove (chondromalacia patella)
39
Q

Hoover Sign

A
  • Positive: Lack of counter-pressure on the healthy side
    • Indicates: Lack of organic basis for paralysis (Malingering/hysteria). With organic hemiplegia, the patient will still exert downward pressure when attempting to raise the paralyzed leg
40
Q

Galeazzi Sign

A
  1. Positive: Difference in height of the knees, if one knee is lower
    • Indicates: Ipsilateral congenital hip dislocation or tibial discrepancy (anatomical short leg)
  2. Positive: Difference in anteriority of the knees, if one knee is anterior
    • Indicates: Ipsilateral congenital hip dislocation or femoral discrepancy (contralateral anatomical short leg)
41
Q

Anterior Innominate Test

A

Positive: The inability to bend at the waist more than 45°, because of either/or:

  1. Radiating pain along the sciatic nerve, either unilateral or bilateral
    • Indicates: Sciatic neuralgia or radiculopathy, etc., possibly due to lumbar disc pathology
  2. Low back pain (lumbar or pelvic regions)
    • Indicates: Anterior (rotational) displacement of the ilium relative to the sacrum
42
Q

Rigid or Supple Flat Feet Test

A
  1. Positive: Absence of medial longitudinal arch in both positions
    • Indicates: Rigid flat feet
  2. Positive: Presence of medial longitudinal arch while seated with a loss of medial longitudinal arch while standing
    • Indicates: Supple flat feet
43
Q

Homans Sign

A
  • Positive: Deep pain in the calf
    • Indicates: Deep vein thrombophlebitis
44
Q

Well-Leg Raising Test of Fajersztajn

A
  1. Positive: Pain down affected leg (Cross-Over Sign)
    • Indicates: Medial disc protrusion
  2. Positive: Decrease in pain down affected leg
    • Indicates: Lateral disc protrusion
45
Q

Kemp Test

A
  1. Positive: Pain usually radicular, recreating existing sciatic pain
    • Indicates: Disc protrusion.
      • In medial disc protrusion Kemps will be positive as the patient is leaning away from the side of pain
      • In lateral disc protrusion Kemps will be positive as the patient is leaning into the side of pain
  2. Positive: Pain - local
    • Indicates: Localized pain may indicate lumbar spasm or facet capsulitis
46
Q

O’Donoghue Maneuver of the Foot and Ankle

A
  1. Ankle Dorsiflexion
  2. Ankle Plantarflexion
  3. Subtalar Inversion
  4. Subtalar Eversion
  5. Positive: Pain during passive range of motion
    • Indicates: Ligamentous sprain (passive range of motion stresses ligaments)
  6. Positive: Pain during resisted range of motion
    • Indicates: Muscle/tendon strain (active range of motion stresses muscles and tendons)
47
Q

Minor Sign

A
  • Positive: Knee flexion of affected leg while supporting upper body weight (hand on back or thigh) on unaffected side
    • Indicates: Sciatica, lumbosacral or sacroiliac joint lesion
48
Q

Valgus Stress Test

(Knee)

A
  • Positive: Gapping and/or elicited pain above/at or below joint line
    • Indicates: Tear and/or instability of the medial collateral ligament
49
Q

Cross-Over Sign

A
  1. Positive: Pain down affected leg (Cross-Over Sign)
    • Indicates: Medial disc protrusion
  2. Positive: Decrease in pain down affected leg
    • Indicates: Lateral disc protrusion
50
Q

Neri Bowing Test

A
  • Positive: Pain accompanied by flexion of the knee on the affected side and body rotation away from the affected side
    • Indicates: Positive with a variety of low back pathologies. Hamstring tension on the pelvis may trigger the response
51
Q

Tinel Foot Sign

A
  • Positive: Paresthesia radiating into the foot
    • Indicates: Tarsal tunnel syndrome
52
Q

Lewin Standing Test

A
  • Positive: Radiating pain down the leg causing flexion of the patient’s knee or knees
    • Indicates: Gluteal, lumbosacral or sacroiliac pathologies
53
Q

Buckling Sign

A
  • Positive: Pain in the posterior thigh with sudden knee flexion (buckle)
    • Indicates: Sciatic radiculopathy
54
Q

Leg Length Discrepancy

A
  • Positive: Different measurements
    • Indicates: True - Bony abnomality above or below the level of trochanteric difference (anatomical short leg) or Apparent - Pelvic obliquity (tilted pelvis)
55
Q

Lateral Collateral Ligament Test

(Knee)

A
  • Positive: Gapping and/or elicited pain above/at or below joint line
    • Indicates: Tear and/or instability of the lateral collateral ligament
56
Q

Lewin-Gaenslen Test

A
  • Positive: Pain on the affected sacroiliac joint stressed into extension
    • Indicates: General sacroiliac joint lesion, anterior sacroiliac ligament sprain, or inflammation of the sacroiliac joint
57
Q

Bowstring Sign

A
  • Positive: Pain in the lumbar region or radiculopathy
    • Indicates: Sciatic nerve root compression, helps rule out tight hamstrings
58
Q

Goldthwait Sign

A
  • Positive: Localized pain, low back or radiating pain down the leg
    • Indicates: Lumbosacral or sacroiliac pathology. Pain occuring after the lumbars spinouses move = possible lumbosacral problem. Pain occuring before the lumbars move = possible sacroiliac problem
59
Q

Ely Test

A
  • Positive: Hip on side being tested will flex causing the buttock to raise off the table
    • Indicates: Rectus femoris or hip flexor contracture
60
Q

Varus Stress Test

(Knee)

A
  • Positive: Gapping and/or elicited pain above/at or below joint line
    • Indicates: Tear and/or instability of the lateral collateral ligament
61
Q

Ankle Dorsiflexion Test

A
  1. Positive: The foot cannot dorsiflex with knee extended, but is able to with knee flexed
    • Indicates: Contracture of the gastrocnemius muscle
  2. Positive: The foot cannot dorsiflex in either knee position
    • Indicates: Contracture of the soleus muscle
62
Q

Nachlas Test

A
  • Positive: Pain in the buttock and/or pain in the lumbar region
    • Indicates: Sacroiliac joint lesion or lumbar pathology
63
Q

Lachman Test

A
  • Positive: Gapping with the tibia moving away from the femur
    • Indicates: Anterior cruciate ligament or posterior oblique ligament instability
64
Q

Apley Distraction Test

A
  • Positive: Patient will point to side of pain
    • Indicates: Pain on the medial side indicates medial collateral ligament tear. Pain on the lateral side indicates lateral collateral ligament tear
65
Q

Bechterew Test

A
  • Positive: Reproduction of radicular pain or inability to perform correctly due to tripod sign
    • Indicates: Sciatic radiculopathy
66
Q

Turyn Sign

A
  • Positive: Pain on the gluteal region or radiating sciatic pain
    • Indicates: Sciatic radiculopathy
67
Q

Milgram Test

A
  • Positive: Inability to perform the test and/or low back pain
    • Indicates: Weak abdominal muscles or space occupying lesion
68
Q

Supported Forward Bending Test

A
  1. Positive: Low back pain while bending with the sacrum stabilized and unstabilized
    • Indicates: Lumbar involvement
  2. Positive: Low back pain during sacrum non-stabilized bending and no pain duing sacrum stabilized bending
    • Indicates: Pelvic involvement
69
Q

Straight Leg Raiser

A
  • Positive: Radiating pain and/or dull posterior thigh pain
    • Indicates: Sciatic radiculopathy or tight hamstrings. Positive between 35-70° = possible discogenic sciatic radiculopathy. Positive greater than 70° = tight hamstrings
70
Q

Ober Test

A
  • Positive: Affected thigh remains in abduction (normal biomechanis, the thigh/hip will adduct)
    • Indicates: Contraction of the iliotibial band or tensor fascia lata (usually secondary to synovitis of the hip, secondary to trauma of the gluteus medius and maximus)
71
Q

Lasegue Test

A
  • Positive: Reproduction of sciatic pain before 60°
    • Indicates: Sciatica
72
Q

Allis Sign

A
  1. Positive: Difference in height of the knees, if one knee is lower
    • Indicates: Ipsilateral congenital hip dislocation or tibial discrepancy (anatomical short leg)
  2. Positive: Difference in anteriority of the knees, if one knee is anterior
    • Indicates: Ipsilateral congenital hip dislocation or femoral discrepancy (contralateral anatomical short leg)
73
Q

Sicard Sign

A
  • Positive: Posterior thigh and leg pain
    • Indicates: Sciatic radiculopathy (usually from disc lesion)
74
Q

Adduction Stress Test

(Knee)

A
  • Positive: Gapping and/or elicited pain above/at or below joint line
    • Indicates: Tear and/or instability of the lateral collateral ligament
75
Q

O’Donoghue Maneuver of the Knee

A
  1. Knee Flexion
  2. Knee Extension
  3. Positive: Pain during passive range of motion
    • Indicates: Ligamentous sprain (passive range of motion stresses ligaments)
  4. Positive: Pain during resisted range of motion
    • Indicates: Muscle/tendon strain (active range of motion stresses muscles and tendons)
76
Q

FABERE Sign

A
  • Positive: Pain in the hip region
    • Indicates: Hip joint pathology
77
Q

Supported Adam Test

A
  1. Positive: Low back pain while bending with the sacrum stabilized and unstabilized
    • Indicates: Lumbar involvement
  2. Positive: Low back pain during sacrum non-stabilized bending and no pain duing sacrum stabilized bending
    • Indicates: Pelvic involvement
78
Q

Heel Walk

A
  • Positive: Inability to perform the test
    • Indicates: L4-L5 disc lesion (L5 nerve root)
79
Q

Anvil Test

A
  • Positive: Localized pain in long bone or in hip joint
    • Indicates: Possible fracture of long bones, or hip joint pathology

7 - CLET Lab (28 decks)

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