Special Test of the Knee

Question 1

What are all the Special test for the knee?

Answer 1

Apley’s Compression, Apley’s Distraction, Bragard’s Sign, Clarke’s, Helfet’s, Lachman’s, Major Effusion, McConnell’s, McMurray’s, Minor Effusion, Noble’s, Posterior Sag, True Tibia / Femur length test, Valgus / Varus Stress test, Waldron’s.

Question 2

What is Apley’s Compression used to Assess for?

Answer 2

Used to assess for Meniscal injury.

Question 3

How is Apley’s Compression performed?

Answer 3

Client prone, with affected knees flexed to 90*.
Compress the flexed knees by pushing the client’s foot and tibia down into the table, followed by int / ext rot of the tibia.

Question 4

What is a positive result for Apley’s Compression?

Answer 4

If the client reports pain in the medial aspect of the joint.
Positive foe medial meniscal injury.
Pain on lateral aspect of the knee is positive for lateral meniscal injury.

Question 5

What is Apley’s Distraction Used to Assess for?

Answer 5

Assess the integrity of the Collateral ligaments of the knee joint.

Question 6

How is Apley’s Distraction performed?

Answer 6

Client prone with knees flexed to 90*.
Stabilize the client’s leg by placing your knee on the posterior thigh.
Apply a traction of the tibia, and internal / External rot.

Question 7

What is a Positive result for Apley’s Distraction?

Answer 7

If the client reports pain on the medial side of the joint the test is positive for MCL damage.
If the pain is on the Lateral Aspect of the Joint, the test is positive for LCL damage.

Question 8

What is Bragard’s Sign used to assess for?

Answer 8

Used to assess for Meniscal Tearing.

Question 9

How is Bragard’s Sign performed?

Answer 9

Client Supine with Hip and Knee flexed,
Externally Rot the Tibia with one hand while extending the knee,
With the other hand stabilize proximal to the knee.

Question 10

What is a positive result for a Bragard’s Sign test?

Answer 10

Pain / Tenderness along the Medial aspect of the joint line.

Question 11

What is Clarke’s Test used to assess for?

Answer 11

Used for assessing Patellofemoral Syndrome.

Question 12

How is Clarke’s Test performed?

Answer 12

Client supine with knees Extended,
Compress patella posteriorly onto the femoral condyles and then, with moderate pressure move the patella distally.
Get client to contract Quads on affected leg.

Question 13

What is a positive result of a Clarke’s Test?

Answer 13

If the client presents with Apprehension, pain or crepitus, the test is positive.
The test may make clients present with these symptoms of apprehension anyway so the test should be performed several times, using gradually increased pressure.

Question 14

What is Helfet’s Test used to assess for?

Answer 14

Used to Assess the Dynamic rotary function of the Tibia.

Question 15

How is Helfet’s Test performed?

Answer 15

Client is seated with legs over edge of table,
Slowly ext knee,
Observe the tibial tuberosity in relation of the midline of the patella.
Look for the slight lateral rot of the tibial tuberosity at the last part of knee ext.

Question 16

What is a positive result for Helfet’s test?

Answer 16

If there is no slight lateral rot of the tibia, this indicates a positive test for possible damaged Cruciate ligament or Meniscal damage.

Question 17

What is Lachman’s used to assess for?

Answer 17

This test is considered to be the most accurate for assessing the integrity of the ACL.

Question 18

How is Lachman’s test performed?

Answer 18

Client supine, with affected knee in 30* of flexion.
Stabilize the distal femur with one hand and grasp the proximal tibia in the other hand, apply anterior directed stress to the Tibia.

Question 19

What is a positive result of a Lachman’s test?

Answer 19

A positive test indicating damage to the ACL, when there is pain or excessive movement of the tibia.

Question 20

What is a Major Effusion test used to assess for?

Answer 20

Used to assess for major increase in synovial fluid within the knee joint capsule following an acute knee injury.

Question 21

How would you perform a Major Effusion test?

Answer 21

Client supine with affected knee in as much ext as possible,
When there is swelling in the knee the client may hold the knee in slight flexion,
Gently but firmly ext the knee, compress the patella down on the femoral condyles and then release it.

Question 22

What is a positive result for a Major Effusion test?

Answer 22

If the patella clicks onto the condyles then rebounds to the floating position, the test is positive for swelling.
Meniscal tearing, torn cruciate ligaments or Fracture may be the causes.

Question 23

What is McConnell’s test used to assess for?

Answer 23

Used to assess for Patellofemoral Tracking problems.

Question 24

How is McConnell’s test performed?

Answer 24

Client seated with legs hanging over table,
Client ext rot the femur of affected leg, while performing AR contractions of the quad.

Note the painful ranges.
Passively bring the clients knee into full ext, glide the affected patella medially and hold it in position.

Get client to perform the Painful ranges.

Question 25

What is a positive result for McConnell's test?

Answer 25

If the client can perform the painful ranges with the medially assisted patella, or the pain decreases dramatically. The test is positive for poor patellar tracking.

Question 26

What is McMurray's test used to assess for?

Answer 26

Used to assess for injury of the menisci.

Question 27

How do you perform a McMurray's test?

Answer 27

Client supine with Hip and knee flexed, Cup one hand over the client's knee with palm over the patella and fingers and thumb over the joint line. Slowly ext the knee while applying stress with valgus / varus stress and ext / int rot of the tibia. 1 direction at a time to test ether the medial or lateral side.

Question 28

What is a positive result for a McMurray's test?

Answer 28

A positive test is indicated by a click or catch in ext of the knee. A negative does not completely rule out a Meniscal tear.

Question 29

What does a Minor Effusion test Assess for?

Answer 29

Used to assess for Lessor amounts of Synovial fluid within the knee joint capsule after an acute injury.

Question 30

How do you perform a Minor Effusion test?

Answer 30

Client supine, with knees in as much ext as possible, | Attempt to slowly brush the fluid from the superior lateral aspect of the knee.

Question 31

What is a positive Minor Effusion test?

Answer 31

If excess fluid present, it may take 1-2 secs to appear inferior to the patella in a bulge. if swelling does not move the test is negative.

Question 32

What is Noble's test used to assess for?

Answer 32

Used to assess for the presence of IT band Friction syndrome.

Question 33

How is Noble's test performed?

Answer 33

Client in supine with both affected Hip and knee in flexion 90*. Firmly but yet tolerably compress the IT band 2 CMs proximal from the lateral condyle of the knee. Instruct client to ext knee and hip slowly while compression is maintained.

Question 34

What is a positive Noble's test?

Answer 34

If the client presents with pain over the lateral condyle of the Femur at around 30* the test is positive for IT band friction syndrome.

Question 35

What does Posterior Sag test assess for?

Answer 35

Used to assess the PCL.

Question 36

How is Posterior Sag test performed?

Answer 36

Client Supine with Hips flexed to 45* and knees to 90*. | Observe the profile of both knees from the side of the table.

Question 37

What is a positive result for a Posterior Sag test?

Answer 37

If the affected Tibia "Sags" posteriorly compared to the unaffected knee.

Question 38

What does a True Tibia and Femur Length test Assess for?

Answer 38

Used to assess Tibia and Femur length.

Question 39

How do you perform a True Tibia and Femur Length test?

Answer 39

Client supine, with hips and knees flexed and feet on table. Knees together and Mallioi even. Stand at the end of the table, compare the heights of tibial plateaus.

Question 40

What is a positive result for a True Tibia and Femur Length test?

Answer 40

Moving side to side comparing the positions of the paellas, looking for a shorter femur.

Question 41

What does a Valgus Stress test Assess for?

Answer 41

Used to assess the MCL / medial aspect of the knee.

Question 42

How do you perform a Valgus stress test?

Answer 42

Client supine, Stabilize affected leg in slight ext rot with one hand on the medial malleolus and the other hand on the lateral aspect of the knee with knee in full ext. Apply a medially directed stress on the knee, when the knee is 20-30* of flexion youre assessing the MLC only.

Question 43

What is a positive result for a Valgus stress test?

Answer 43

In ether full ext or the knee is in 20-30* of flexion, it is indicated by pain in the injured tissues and excessive movement or gapping at the medial aspect of the knee.

Question 44

What does a Varus stress test assess?

Answer 44

Used to assess the Lateral aspect of the knee / LCL.

Question 45

How would you perform a Varus stress test?

Answer 45

Client supine, Stabilize leg in slight ext rot. One hand on the lateral malleolus and the other hand on the medial aspect of the knee. Applying a Lateral stress to the joint from the medial knee.

Question 46

What is a positive result for a Varus stress test?

Answer 46

Excessive movement at the affected tissue / gapping or pain on ether full ext or in 20-30* of flexion.

Question 47

What does Waldron's test assess for?

Answer 47

Used to assess for Patellofemoral Syndrome.

Question 48

How would you perform Waldron's test?

Answer 48

Client Standing, | Palpate affected patella while the client performs a number of slow deep knee bends / Squats.

Question 49

What is a positive result for a Waldron's test?

Answer 49

Crepitus, pain or poor patellar tracking indicates a positive result.