Savarese CH 18: Special Tests

Question 1

What is the Patrick/FABERE Test used for?

Answer 1

Used to assess pathology of the sacroiliac and hip joint. (Especially osteoarthritis of the hip)

Question 2

What is the position for the Patrick Test?

Answer 2

FABERE:

Position of the hip: Flexion, ABduction, External rotation, and Extension. (into a figure 4)

Question 3

How is the Patrick/FABERE test performed?

Answer 3

After positioning, any pain in or around the hip joint indicates general pathology of that hip joint.
Then, Physician places one hand on the contralateral ASIS and other hand on the knee of the testing leg. Pressure is placed downward on both parts (focusing on further extension of the hip).
Pain will be accentuated by any arthritic changes in the hip or sacroiliac joint.

Question 4

What is a Thomas Test used for?

Answer 4

It assesses the possibility of a flexion contracture of the hip. (Usually of iliopsoas origin).

Question 5

How is the Thomas Test performed?

Answer 5

Patient lies supine.
Check for exaggerated lumbar lordosis (common in hip flexion contractures)
Physician flexes one hip to abdomen. If a flexion contracture is not present, the patient’s opposite leg will remain flat on the table.

Question 6

What does the Ober Test detect?

Answer 6

Detects a tight tensor fascia lata and iliotibial band.

Question 7

How is the Ober Test performed?

Answer 7

-Patient lies on contralateral side of testing
-Physician flexes the superior knee to 90 degrees, ABducts the hip as far as possible, and slightly extends the hip while stabilizing the pelvis. (Extension ensures that the IT band passes directly over the greater trochanter).
-Physician slowly allows the thigh to fall to the table.
Positive = thigh remains in the abducted position.

Question 8

What does a positive Ober test mean?

Answer 8

Tight iliotibial band.

Question 9

What does the Trendelenberg Test assess?

Answer 9

Assesses gluteus medius muscle strength

Question 10

How is the Trendelenberg Test performed?

Answer 10

• Patient is instructed to pick one of the legs up off the floor.
• Positive test = the pelvis falls, indicating weakness in the gluteus medius muscle.

Question 11

How would a weak left gluteus medius muscle present upon testing?

Answer 11

Patient picks up the right leg off the floor (Trendelenberg Test).
The patients RIGHT hip falls.

Question 12

What is the principle of the spurling test/compression test?

Answer 12

Narrowing of the neural foramina can cause referred pain into the ipsilateral arm upon compression of the c-spine due to nerve root compression

Question 13

How is the Spurling Test performed?

Answer 13

Patient seated
Physician extends and SB the c-spine to the side ebing tested
Compress head caudally

Question 14

What does a positive spurling test look like?

Answer 14

Positive test if pain radiates into the ipsilateral arm.

Question 15

What does the Wallenberg’s Test test for?

Answer 15

Tests for vertebral artery insufficiency

Question 16

What does a positive Wallenberg’s Test look like?

Answer 16

Positive when the patients complains of dizziness, visual changes, lightheadedness, or eye nystagmus

Question 17

What is the significance of the Underberg’s test?

Answer 17

If this is positive, DO NOT perform cervical HVLA.

Question 18

When is an Adson’s Test performed?

Answer 18

Looking at Throacic Outlet syndrome.

Question 19

How do you perform the Adson’s test?

Answer 19

Monitor radial pulse.
Extend at elbow, extend at shoulder
externally rotate, slightly abduct
Patient takes a deep breath, rotate head toward the ipsilateral arm