Special Tests Flashcards
Straight Leg Raising Test
Technique: lay on back relaxed, adduct and internally rotate LE with knee straight, flex hip to 70˚ (pain = positive)
Correlates: radiculopathy (discogenic or nerve root pathology)
1-Leg (Stork Standing) Lumbar Extension Test
Technique: stand on one foot and actively extend lumbar spine (pain = positive), rotation toward support leg (pain = positive)
Correlates: spondylopathies - spondylolisthesis (slipped vertebrae) or spondylolysis (fracture)
Adam’s Forward Flexion (Bend) Test
Technique: patient stands and bends forward at hips (rib hump = positive)
Correlates: scoliosis (rib hump on convex side of curve)
Apley’s Scratch Test
Technique: touch fingers together behind back
Correlates: functional tri-planar shoulder ROM
reaching above = flexion + abduction + external rotation
reaching below = extension + adduction + internal rotation
Load & Shift Test
Technique: patient seated upright, hand on thigh, shoulder relaxed; grasp humeral head and apply force A-P to displace humeral head in glenoid
Correlates: GH joint laxity / instability
Translation of humeral head:
<25% = normal
26-50% = grade 1
>50% and humeral head pops back = grade 2
>50% humeral head does not pop back = grade 3
Sulcus Sign
Technique: patient stands with arm relaxed at side; apply downward force at elbow
Correlates: GH multi-directional instability
<1cm = 1+
1-2cm = 2+
>2cm = 3+
bilaterally equal is not clinically significant
Hawkins-Kennedy Impingement Test
Technique: flex shoulder and elbow to 90 deg each, internally rotate shoulder (pain = positive)
Correlates: subacromial impingement (esp. supraspinatus tendon)
Speeds Test
Technique: patient resists downward force on forearm with elbow flexed to 90 (pain = positive)
Correlates: biceps tendonitis
Supraspinatus (Empty Can) Test
Technique: shoulder abducted to 90 and set to 30-45 deg horizontal adduction, resist downward force at wrist (weakness and/or pain = positive)
Correlates: supraspinatus or subscapular nerve injury
Milking Maneuver
Technique: elbow flexed to 90 and supinated, stabilize humerus and pull thumb to impart valgus stress to elbow (pain or laxity = positive)
Correlates: MCL injury at elbow
Varus Stress (elbow) Test
Technique: elbow flexed 20-30 deg, stabilize humerus and apply lateral directed force at elbow and medial directed force at distal forearm (pain or laxity = positive)
Correlates: LCL injury at elbow
Tinel’s Sign (elbow)
Technique: elbow slightly flexed, tap ulnar nerve at elbow (tingling along ulnar nerve = positive)
Correlates: ulnar nerve entrapment
Finger Ligamentous Instability Test
Technique: apply medial and lateral directed forces across each IP joint (pain or laxity = positive)
Correlates: collateral ligament laxity
Thumb UCL Laxity Test
Technique: extend IP/MCP at thumb and apply valgus stress (can also flex MCP to 30)
Correlates: ulnar collateral ligament sprain
valgus degree:
<30-35˚ = partial UCL tear
>30-35˚ = complete UCL tear
Finklestein’s Test
Technique: make fist holding thumb, passively deviate wrist in ulnar direction ( (pain along abductor pollicis and extensor pollicis brevis = positive)
Correlates: DeQuervain’s tenosynovitis
Tinel’s Sign (wrist)
Technique: firmly tap anterior fprearm over carpal tunnel (tingling or pain along median nerve = positive)
Correlates: median nerve compression / carpal tunnel syndrome
Phalen’s Test
Technique: flex wrist and push back of hands together for 1 minute (tingling or pain along median nerve = positive)
Correlates: median nerve compression / carpal tunnel syndrome
Froment’s Sign
Technique: patient grabs piece of paper using lateral prehension, examiner tries to pull it away (IP flexes to maintain grip = positive)
Correlates: ulnar nerve lesion and/or paralysis of adductor pollicis
Patrick’s (Figure 4 / FABER) Test
Technique: patient lies on back with legs in number “4” position, slowly lower knee of test leg toward table (cannot reach at least parallel to opposite leg = positive)
Correlates: limitation in hip joint ROM
Trendelenburg Sign
Technique: stand on one leg (pelvis on contralateral side drops when standing on affected leg = positive
Correlates: hip abductor weakness / hip instability of stance leg
Craig’s Test (Ryder Method)
Technique: lie on stomach w/knee flexed to 90, palpate greater trochanter and position parallel to exam table - measure tibial crest relative to vertical
Correlates: femoral anteversion or retroversion
normal 8-15˚
medial femoral torsion = anteversion (in-toe)
lateral femoral torsion = retroversion (out-toe)
True Leg Length Test
Technique: measure legs ASIS to distal medial malleolus
Correlates: leg length discrepancy
measurement discrepancy 1.5cm or less = WNL
Thomas Test
Technique: patient lies on back, check for excessive lordosis, flex one hip bringing knee to chest (straight leg does not remain flat on table = positive)
Correlates: hip flexion contracture
Ober’s Test
Technique: patient lies on side, examiner passively abducts and extends upper leg with knee straight or flexed to 90 (top leg cannot lower to table behind bottom leg = positive)
Correlates: tensor fascia lata / IT band tightness or inflammation
