Special MSK Joint Tests Flashcards
Ankle Anterior Draw
Tests for ATFL instability/ tear
Pt foot off end of bed, pull calcaneus forward.
+ive if increased movement, pain, laxity
Talar Tilt
Tests CTFL, ATFL, deltoid ligament
Pt prone, knee bent, foot in air, hold calcaneus invert at talus.
+ive if more movement, pain, laxity
Thompson’s Test
Tests for achilles tendon rupture
Pt kneeling off end of plinth, squeeze down bulk of gastroc.
+ive if no/abnormal plantar flexion
Lachman’s
Tests ACL rupture
Pt supine, slight hip and knee flexion, hand under JL and apply PA movement
+ive if increase movement or laxity, more noticeable joint line
Knee Anterior Draw
Tests ACL rupture
Pt supine, knee bent, foot flat on plinth, sit on to stabilise, hands around tibial tuberosity and posterior joint line, pull tibia forward.
+ive if increased tibial glide, laxity, more noticeable JL
Knee Posterior Draw
Tests PCL rupture
Pt supine, knee bent, foot flat on plinth, sit on to stabilise, hands around tibial tuberosity and posterior joint line, push tibia backwards AP.
+ive if increase tibial glide, pain
Posterior Sag Sign
Tests PCL rupture
Pt long sitting, hip flex knee flex 90, lift pt leg to 90/90 flexion, hold by calcaneus
+ive if sagging below patella
Valgus Stress Knee
Tests MCL rupture
Pt supine, shotgun hand position, one hand lateral knee, one hand medial malleolus, apply LM on lateral knee and ML on malleolus
+ive if increased gapping on medial JL
Varus Stress Knee
Tests LCL rupture
Pt supine, shotgun hand position, one hand medial knee, one hand lateral malleolus, apply ML on medial knee and LM on lateral malleolus
+ive if increased gapping on lateral JL
McMurrays
Tests meniscal tear
Pt supine, hold calcaneus sole of foot going up forearm, thumb and pinky either side by malleolus, support under JL to 90 knee flex then change to lateral knee to apply adduction force, externally rotate foot for medial meniscus, internally rotate foot for lateral meniscus, adduct knee and extend knee with lower hand
+ive if crepitus, pain, popping, locking, catching
Apley’s Grind Test
Tests meniscal tears
Pt prone, knee bent foot in air, hold distal tib/fib, apply rotational pressures, then add downwards pressures with rotation
+ive if pop, crepitus, locking, catching
Thessaly’s Test
Tests meniscal tears
Pt standing on 1 leg, hold onto physio hands for support, slight bend in knee, internal and external rotate.
+ive if popping, crepitus, locking, catching, pain
Clark’s PF Grind Test
Tests PF joint
Pt supine, knee straight, tests quads contraction, apply downward force with thenar eminence above patella then flatten palm, get pt to contract quads.
+ive if crepitus, pain, popping
Trendelenburg Sign
Tests weak hip stabilisers
Pt stand on one leg, bring other knee to chest.
+ive if drop hip laterally or posterior
Obers Test
Tests hip tightness - ITB, TFL
Pt side lying, bottom leg bent, fix hip with one hand, support under top leg knee with other arm hook lower leg around body, extend, abduct top leg, squat down to adduct leg.
+ive if fail to drop as low as other hip
FABER/ FADIR
Tests hip mobility
Pt prone
FABER - figure 4 position, flex hip, abduct, external rotate
FADIR - flex, adduct, internal rotate, take knee towards other hip
Add passive over pressure if pain free
+ive if knees not level, pain, catching, tightness
Quadrant Test
Tests back of capsule hip pathologies
Pt supine, flex hip and adduct, apply downward pressure through top of knee through femur, move through semi-circle motion of hip flexion
+ive if decreased ROM, pain, crepitus
Thomas Test
Tests for hip flexibility - iliopsoas, rec fem
Pt supine, bring knee to chest with a flat back
Modified - perch on end of plinth, hug on knee and roll back onto back with other leg off end of plinth.
+ive if other leg lifts off surface, abducts, externally rotates
Straight Leg Raise
Tests sciatic nerve extensibility
Pt supine, knee straight, raise leg to max hip flex with straight knee. lower and add dorsiflexion and lift, add passive neck flexion
+ive if decreased range, nerve symptoms
Finkelstein Test
Tests for abductor pollicis longus and extensor pollicis brevis tendinopathy
Tuck thumb in fist and ulnar deviate
+ive if pain down thumb
Tinel’s Sign
Tests for carpal tunnel syndrome
Pt palm up, light tapping over median nerve around carpals
+ive if symptoms reoccur
Phalen’s
Tests for carpal tunnel syndrome
Flex wrists and put back of hands together
+ive if symptoms reoccur
Reverse Phalens
Tests for carpal tunnel syndrome
Extend wrists and palms together
+ive if symptoms reoccur
Carpal Compression Test
Tests for carpal tunnel syndrome
Wrist on table, palm up, physio 2 thumbs press down on median nerve by carpals
+ive if symptoms reoccur
Elbow Varus/ Valgus Stress Tests
Tests for medial/ lateral collateral ligament laxity
Pt supine, elbow 15 flex, palpate joint line, thumb over ligament being tested, apply LM/ML force avoiding upper limb movement.
+ive if pain or increase laxity
Cozen’s Test
Tests for tennis elbow
Pt slight elbow flexion, pronates, makes fist, radial deviates, physio resist wrist extension
+ive if pain/ weakness on lateral epicondyle
Golfers Elbow Test
Tests for medial epicondylitis
Pt supinate, elbow and wrist extension, palpate medial epicondyle (resist flexion)
+ive if pain reproduced
Tinel’s of the Elbow
Tests for ulnar nerve
Pt full elbow flexion, tap ulnar nerve in ulnar nerve groove for 30 seconds
+ive if symptoms reproduce (p&n/ numbness)
Empty Can Test
Tests for shoulder impingement/ subacromial pain syndrome
Pt shoulder 90 elevation in scapular pain, maximal internal rotation, physio resist flexion
+ive if pain or weakness
Hawkins Kennedy Test
Tests for subacromial pain syndrome/ impingement
Raise pt arm to 90 forward flexion, put one arm under theirs and rest on their opposite shoulder, allow testing arm to rest on top of your arm, passively move them into internal rotation (pull forward downwards)
+ive if pain
Neer Test
Tests for subacromial pain syndrome/ impingement
Pt arms straight in front of them, fully internal rotate and flex shoulders lifting arms above head
+ive if anterior pain
Painful Arc
Tests for subacromial pain/ impingement, rotator cuff tear
Pt goes through range of abduction
+ive if pain between 60-120 degrees
Resisted External Rotation
Tests for subacromial pain syndrome/ impingement, rotator cuff tear
Pt elbow flexed at side, resist external rotation
+ive if pain or weakness
Drop Arm Test
Tests for rotator cuff tear (supraspinatus)
Pt seated, passively lift their arm into abduction, support under elbow, release elbow and ask pt to slowly lower arm
+ive if pain on lowering, sudden drop, weakness in maintaining position
Apprehension Test
Tests for anterior labrum tear / instability
Pt supine, shoulder 90 abduction, 90 elbow flexion, passively move pt into full external rotation
+ive if doesn’t allow full ER, anterior pain, feeling of dislocation
Relocation Test
Tests for Tests for anterior labrum tear, instability
Pt supine, shoulder 90 abduction, 90 elbow flexion, apply AP glide on GHJ passively move pt into full external rotation, move to neutral before removing AP
+ive if improvement of symptoms
Sulcus Sign
Tests for general instability, inferior labrum tear
Pt seated, observe and palpate for gap between acromion and humeral head, hold pt arm below elbow and pull downwards
+ive if gapping occurs
Load and Shift
Tests for instability, anterior/ posterior labrum tear
Pt sitting, stabilise acromion with one hand, grip humerus below deltoid, shift humerus forwards and backwards
+ive if increased mvm compared to other side, pain
Lumbar Spinous Processes Accessory Movements
Tests for equal mobility between L1-L5
Pt prone, pillow under abdomen, put pisiform on spinous processes, apply PA to each spinous process
Lumbar Transverse Process Accessory Movements
Tests for equal joint rotation
Pt prone, 3 thumb widths away from spinous process, apply PA onto transverse process, should be hard feel not squidgy
Lumbar Flexion PPIVM
Tests for ROM and ligament tension
Pt side lying – thigh half off side of plinth 90 hip flexion knees bent, physio wide stance, pt shins resting on upper thigh support feet with hand, shift weight between legs to increase flexion/ extension, palpate between spinous processes for supraspinous ligaments starting at S1/L5, move pt between flexion and extension feel for joint opening and closing, once palpate ligament tightness, move up a level and repeat
Cluster of Laslett
distraction test, compression test, thigh thrust, sacral thrust
2/4 positive tests for diagnosis
Claster of Van der Wurff
distraction test, compression test, thigh thrust, gaenslens test, FABER
3/5 positives for diagnosis
Distraction Test SIJ
pt supine, crossed arms, hands on ASIS, apply 3-6 downward compressions increasing pressure
+ive if pain
Compression Test SIJ
pt side lying, affected side up, hip flex 45 knee 90 flex, both hands on iliac crest and apply downward pressure
+ive if pain on gluteal area/ L5
Thigh Thrust Test SIJ
pt supine, affected leg 90 hip flex, hip adduction, hold knee with hands and apply downward force onto femur through knee, stand on asymptomatic side
+ive if pain
Sacral Thrust SIJ
pt prone, palm over S2, apply pressure downwards
+ive if pain
Gaenslen’s Test
pt supine, stand on affected side, non affected hip maximal flexion and slight abduction, lower symptomatic hip into extension and passive over press
+ive if pain
Patrick Sign Test (FABER) SIJ
pt supine, knee flex, ankle over other knee, fix opposite ASIS, symptomatic side lower leg outwards, apply over pressure
+ive if pain
Spurlings Test (neck)
Tests for radiculopathy
Pt sitting, side flex head, rotate and slightly extension, physio push down on top of head
+ive if symptoms reoccur in arm on side of side flexion
Neck Distraction
Test for radiculopathy
pt supine, hand under occiput and chin, pull head away mainly from occiput
+ive if decreased radiculopathy symptoms
Deep Neck Flexors Endurance Test
to test neck flexor endurance
pt supine, tuck chin in and elevate head off plinth, hold for 10 secs rep x3
+ive if cannot hold or struggling
Flexion-Rotation (neck)
Tests mobility of C1/C2
pt supine - lift head to full flexion and rest on belly of physio, rotate head around each way passively, should reach line of axilla
+ive if restricted mvm
Cervical Spinous Process Accessory Movements
Tests for equal joint mobility between C1-T3
pt prone, slight neck flexion, physio stand at head facing towards toes, put thumbs on top of each other on spinous processes, apply PA to each
Cervical Lateral Masses Accessory Movements
Tests for equal joint rotation
Pt prone, come lateral to spinous processes, overlap thumbs, thumb on same side at the bottom and apply pressure from opposite thumb to rotate
