Special Test Knee Flashcards
In the classical way, the
examiner holds the
patient’s knee in between
full extension and 30
degrees flexion. Stabilize
femur with one hand.
Classic Lachman Test
the patient is sitting with the leg
over the edge of the examining table. The examiner supports the
patient’s leg with his thigh so that the knee is flexed @30 degrees.
Modification 1
For examiners with small hands, the patient
rests his knee on the examiner’s knee. One hand
of the examiner stabilizes the femur against his thigh
and the other applies anterior stress.
Stable Lachman or Modification 2
The leg to be examined is abducted off the side of the examining
table and the knee is flexed to 25 degrees. One hand stabilizes the femur while the other applies anterior force. It was said that this modification produces greater anterior laxity.
Drop Leg Lachman Test or Modification 3
The examiner stabilizes the foot
between the examiner’s thorax and arm. Both hands
are placed on the tibia and the knee is flexed @ 20-30 degrees. Then, an anterior drawer movement is performed.
Modification 4
the examiner stands beside the
test leg. The examiner stabilizes the femur with
one hand and the tibia with the other. The tibia is then
pulled forward and any abnormal motion is noted
Modification 5
The patient lies prone and stablizes the
foot between the examiner’s thorax and arm.
One hand stabilizes the femur and another is around the tibia.
Prone Lachman Test or Modification 6
the patient places his knee over the examiner’s
forearm so that it is approximately flexed
@ 30 degrees. The patient is then asked to actively extend the knee.
Active Lachman Test or Modification 7
It has a similar the procedure with the previous
modification, but the foot is held down on the table.
Maximum Quadriceps Test or Modification 8
- The examiner stabilizes the ankle, and the knee is fully
extended (method 1) - externally rotated or flexed @ 20-30 degrees (method 2)
- It can also be done with the knee extended while
grasping the patient’s big toe and applying valgus
force (Hughston’s valgus stress test/method 3)
Abduction Test/ Valgus Stress Test
- The examiner stabilizes the ankle and the knee is fully
extended. (method 1) - flexed @ 20-30 degrees (method 2)
- It can also be done with the knee extended while
grasping the patient’s fourth and fifth toe and applying
valgus force (Hughston’svalgus stress test/method 3)
The examiner then applies a varus force to the knee
Adduction Test/ Varus Stress Test
- The examiner’s knee is positioned @ a 45-degree
angle. - The examiner golds the patient’s foot down. The patient is then asked to straighten the leg while the examiner prevents him actively.
Active Drawer Test or Quadriceps Active Test
- The patient’s knee is passively flexed to 90
degrees and hip is flexed to 45 or 90 degrees. - The examiner then draws the tibia anteriorly.
Drawer Sign
The examiner holds both legs while flexing the
patient’s hip and knee to 90 degrees.
Godfrey Test or Gravity Test
The patient’s hip is flexed to 45 degrees and the knee is
flexed to 90 degrees. This position promotes the tibia
“drops back” or sags back on the femur because of gravity.
Posterior Sag Sign (Gravity Drawer Test)
The examiner holds the patient’s leg in an extension
with one arm against the body and the hand under
the calf to lift the tibia while applying a valgus stress
Dejour Test
- The patient’s knee is flexed to 80 or 90 degrees and the hip is flexed to 45 degrees.
- The patient’s foot is first placed in 30 degrees medial rotation and then the examiner sits on the patient’s forefoot and draws
the tibia forward.
Slocum Test
- The patient sits with the foot on the floor in neutral
rotation and the knee flexed to 80 or 90 degrees. - The patient is asked to contract the
quadriceps while the examiner stabilizes the foot isometrically.
Active Pivot Shift Test
- The examiner flexes the patient’s hip to 45 degrees
and the knee to 90 degrees. - The examiner then applies a valgus force to the knee
while simultaneously extending the knee
Jerk Test of Hughston
- The patient lies supine with the hip both flexed and
abducted to 30 degrees and relaxed in slight IR @ 20 degrees - The examiner golds the patient’s foot with one hand
while the other is placed at the knee, holding the leg in slight IR. - The examiner applies a valgus force to the knee while simultaneously flexing the knee.
Lateral Pivot Shift Maneuver (Test of Macintosh)
- The patient’s knee is flexed to 80-90 degrees, and the
hip is flexed to 45 degrees. - The examiner medially rotates the patient’s foot
slightly and sits on the foot to stabilize it. The
examiner then applies a posterior force on the tibia.
Hughston’s posteromedial and posterolateral drawer sign.
- The patient lies prone with the knee flexed to 90 degrees. The
patient’s thigh is then anchored to the examining table with the
examiner’s knee. - The examiner medially and laterally rotates the tibia,
combined with distraction while noting any restrictions,
excessive movement or discomfort.
Appley’s Test
- The examiner’s hand cupped the patient’s heel, with the
patient’s knee completely flexed. Then, the knee is allowed to extend passively
Bounce Home Test
- The patient lies supine with the knee was completely flexed.
- The examiner then medially rotates the tibia and extends
the knee.
McMurray Test
- The examiner flexes the patient’s knee to 90 degrees,
rotates it medially and laterally twice, and then fully flexes and rotates it both ways again
O’Donohue’s Test
- The patient lies supine and the examine flexes the patient’s
knee and medially rotates the tibia with one arm while
pressing the patella medially with the heel of the the other
hand and palpating the medial femoral condyle. - Te patient’s knee is then passively flexed and extended
while the examiner feels for popping.
Hughston’s Plica Test
- The examiner commences the stroking just below the joint line
on the medial side of the the patella, stroking proximally
towards the patient’s hip two or three times. - With the opposite hand, the examiner strokes down on the lateral side of the patella.
Brush, Stroke, or Bulge Test/ Wipe Test
With the patient’s knee extended or flexed to discomfort, the examiner applies a slight tap or pressure over the patella.
Patellar Tap Test (Ballotable Patella)
- The examiner pressed down on the patella with the web of
the hand. - The patient is then asked to contract the quadriceps
muscles while the examiner pushes down.
Clarke’s Sign
- The patient performs isometric quadriceps
contractions @ 120, 90, 60, 30, and 0 degrees with
each contraction is held for 10 seconds. - If pain is produced at any angle, the examiner places
a medial glide towards the patella, and the patient
performs isometric quadriceps contraction again.
Mcconnel Test for Chondromalacia Patellae
- The patient stands beside a stool that is 25 cm (10 in.)
high. - The examiner asks the patient to step up sideways
onto the stool using the good leg. The test is repeated with the other leg. - Normally, the patient should have no difficulty doing the
test and have no pain
Step-up Test
The examiner palpates the patella while asking the
patient to perform several slow deep knee bends.
Waldron’s Test (Squat Test)
The patient lies supine with quads relaxed and knee flexed
to 30 degrees while the examiner slowly pushes the
patella laterally and distally.
Fairbank’s Apprehension Test
The examiner selects areas where muscle bulk or swelling
is greatest and measures the circumference of the leg.
The following are the common measure points:
● 15 cm (6 in) below the apex
of the patella
● Apex of the patella or joint
line.
● 5 cm (2 in) above the base
base of patella
● 10 cm (4 in) above the base
of patella
● 15 cm (6 in) above the base
of the patella
● 23 cm (9 in) above the base
of the patella
Measurement of Muscle Bulk/ Anthropometric Measurement’s For Efussion and Atrophy
