OSCE 2

Question 1

Anterior innominate

Answer 1

unaffected foot forward and flexes at waist attempts to touch toe, look for rear heel to lift off. Local pain over SI joint

Question 2

Belt Test

Answer 2

First patient bends forward and touches toes, then doc braces hips and patient repeats. pain first part but not second SI, pain in both Lumbar

Question 3

Erichsen’s Test

Answer 3

patient prone, compress Si joints by pushing in on the PSIS, elicit pain in the SI joint

Question 4

Gaenslen’s Test

Answer 4

patient supine, doctor stands on side and brings unaffected knee up to patient’s chest, looking for SI. SI joint pain on side being tested or radiating pain to thigh or groin

Question 5

Goldthwait’s sign

Answer 5

How much does gold weigh. pain before L5-S1 separation it is SI; after it is lumbar

Question 6

Hibb’s Test

Answer 6

patient prone, flex knee to 90 then internally rotates femur by pushing foot laterally, sacroiliac lesion with positive test which is pain

Question 7

Iliac compression test

Answer 7

patient on unaffected side, doctor compresses iliac crest, sprain of posterior SI ligament, SI joint inflammation or sublux; pain is positive

Question 8

Lewin Gaenslen Test

Answer 8

patient lies on unaffected side and brings unaffected knee toward chest, doc slowly hyper-extends affected thigh, SI joint sprain or arthritis

Question 9

Yeoman’s Test

Answer 9

patient lies prone and doctor applies pressure to sacrum with one and places hand under affected side knee and lifts that knee off table; SI joint issues, femoral nerve irritation, Iliopsoas or rectus femoris muscle contraction

Question 10

Actual leg length

Answer 10

ASIS to medial mal difference greater than 6mm, hip defficiency

Question 11

Apparent Leg length

Answer 11

umbilicus to center medial mal, spinal or pelvic sublux difference greater than 6mm

Question 12

Allis’ sign (Galeazzi’s)

Answer 12

supine with feet flat on table looking for tibial and femur length discrepancy

Question 13

Anvil Test

Answer 13

doc elevates foot then hits bottom of foot, looking for fracture in any one of the bones leading to hip or hip arthritis

Question 14

Gauvain’s Sign

Answer 14

patient with affected side up, one hand on abdominals and the other just above ankle, abduct the leg the internally and externally rotates thigh. looking for AVN, infection, fracture or gout; ipsi contraction of abs, pain in hip, reffered pain groin and anterior thigh

Question 15

Hip Telescoping test

Answer 15

patient supin doctor felxes hip and knee on affected side. Doc grasps calf and thigh on affected side, other hand on thigh just above knee, push femur into table and distract femur; hip dislocation or dysplasia

Question 16

Patrick’s Test

Answer 16

stand on unaffected side, instruct patient to make figure 4 position, stabilize the opposite ASIS on table and downward pressure on 4; hip pathology

Question 17

Ober’s TEst

Answer 17

affected side up, doc stand behind, doc uses other hand to abduct and extend the thigh and hip (done with knee bent at 90) then slide hand to angle and let knee adduct; spastic contractions IT band related

Question 18

Thomas Test

Answer 18

patient supine, actively pulls unaffected knee to chest while keeping other straight; contracture of iliopsoas on affected side, lumbar maintains lordosis or unable to keep thigh flat on table

Question 19

Trendelenburg’s Test

Answer 19

patient stands on affected foot and raises unaffected foot off ground, observed for pelvic unleveling; look for paralysis or weakness of hip abductors on affected side, high iliac crest on supported leg and low on lifted

Question 20

Ortolani’s TEst

Answer 20

infant supine, doctor grasps both thighs at level of less trochanter, doctor flexes and abducts thighs bilaterally; congenital femoral dislocation or instability, click or clunk

Question 21

Valgus/Varus test

Answer 21

supine with leg bent to 30, doc stabilizes medial ankle lateral sides of knee, then foot between legs and wiggle back and forth; pain or increased motion

Question 22

Apley’s Compression

Answer 22

Patient prone with knees flexed at 90, doc grasps foot, pushes down and medially/laterally rotates foot; meniscus tears, internal lateral meniscus, external medial meniscus

Question 23

Patella Ballottement Test

Answer 23

patient supine with leg straight, doc pushes down on patella, moves it lateral and medial; looking for boggy feel

Question 24

Bounce Home Test

Answer 24

Patient lies supine, doc lifts leg and bends to 20, doc allows knee to drop into full extension; meniscal tear, pain or inability to fully extend

Question 25

Clarke’s Sign

Answer 25

patent lies supine and doc applies S-I pressure on top of patella, patient contracts the quads; chondromalacia patella or degeneration of patellofemoral joint

Question 26

McMurray Sign

Answer 26

patient supine with hip and knee at 90, doc graps knee and heel then rotates tibia externally while applying varus stress while extending then perform opposite motion, meniscal tears

Question 27

Lateral Pivot Shift Maneuver

Answer 27

patient supine with hip and knee at 5, doc applies internal rotation, valgus stress and flexes knee; ACL tear, patient feels like knee is going to pop or give out

Question 28

Lachman Test

Answer 28

Test for ACL, same as Drawer test but knee flexed to 25-30, doc holds femur and lifts Tibia; pain normal translation sprain, patin with increased translation rupture

Question 29

Drawer test

Answer 29

Patient supine with knee at 90, doc sits on patient’s foot, doc pulls tibia and pushes tibia; excess translation

Question 30

Q-Angle Test

Answer 30

patient standing, draw line from ASIS through midpoint of patella, then another from tibial tuberosity to patella; angle less than 13 patellofemoral dysfunction or patella alta, angle greater than 18 suggests patellofemoral dysfunction