Special tests Flashcards
Knee to wall test
Tests: AROM
measures dorsiflexion in weight bearing. Place foot away from wall and lean forwards as far as possible. Measure distance between knee and wall and place finger in front of toes before swapping feet to ensure fair test.
Anterior drawer test (ankle)
Tests PROM
Patient placed in prone position with ankle extending beyond bed, Talofibular joint stabilise, Heel held and anterior force applied. Positive result: excessive anterior movement of foot and dimpling of skin besides Achilles tendon.
medial/ lateral talar tilt
Tests PROM
Sitting. Foot positioned in 10-20º plantarflexion, Distal leg stabilised and hind foot inverted.
Positive result: significant inversion as compared to other foot
Squeeze test
Tests PROM Syndesmosis
Compression of proximal fibula against the tibia.
Positive result: pain occurs indicating fracture or diastasis.
External rotation stress test
Tests PROM syndesmosis
Patient seated with knee flexed to 90º, Stabilise joint, Externally rotate foot.
Positive result: pain at site of interosseus membrane or medially.
Shuck test
Tests PROM syndesmosis
Patient seated with knee flexed to 90º, Joint stabilised and hand holding calcaneus with forearm under foot, Move foot side to side.
Positive result: pain and movement of tibia and fibula within joint
Resisted ankle eversion through range
Tests peroneal dislocation
Place foot in inverted, plantarflexed position. Patient should then resist eversion and dorsiflexion against physio.
Positive result: peroneus longus tendon dislocates and moves on top of lateral malleolus
Lachman test
Tests ACL
place knee joint in 30° flexion, hold posterior part of tibia and use other hand to apply contrary force moving femur down and tibia/fibula up. Positive test- lots of joint movement
Anterior drawer test (knee)
Tests ACL
place knee in 90° flexion, sit on foot and place hands on the back of the leg with thumbs on tibial tuberosity and pull lower leg towards you. Positive test- lots of displacement
Posterior drawer test (knee)
Tests PCL
place knee in 90° flexion, sit on foot and place hands on the back of the leg with thumbs on tibial tuberosity and push lower leg towards plinth. Positive test- lots of displacement
Sag sign
Tests PCL
Place knees at 90° and observe tibia in relation to femur.
If one tibia is more posterior it is a positive test- there is a sag there.
MCL stress test
Tests MCL
lay patient on their back. Put your knee on plinth to anchor yourself. Grab distal part of femur and distal part of tibia. Flex leg to 30°. Push femur medial and pull tibia laterally
LCL stress test
Tests LCL
A varus stress test is performed by stabilizing the femur and palpating the lateral joint line. The other hand provides a varus stress to the ankle. The test is performed at 0° and 20-30°, so the knee joint is in the closed packed position. The physiotherapist stabilize the knee with one hand, while the other hand adducts the ankle
McMurray test
Tests menisci
Patient supine, flex knee to 90° for medial meniscus- medial rotation of tibia and extend the knee. For lateral meniscus, laterally rotate tibia and extend the knee. Positive result is pain and knee giving way/blocking
Apprehension test (knee)
Patellofemoral test
Move patella laterally and compress. Positive test is pain
Clarke’s sign test
Patellofemoral test
with one hand compress patella, glide it inferiorly and ask patient to contract
Ober’s test
Iliotibial band test
Side lying with knees flexed. Hold up leg at the knee and flex to 90° drop knee and positive test of hip keeps extended but a normal test the knee will touch the plinth.
Thomas test
Tests knee extensors
pt holds leg while sitting on the edge and then leans back till they’re lying down.
Positive test- hip will be flexed and may be some knee flexion.
FABER test
pt supine flex knee and hip, abduct hip and externally rotate and assess for pain and where it is coming from
FADDIR test
Flexion, adduction and internal rotation. Assess for pain inside the hip.
Trendelenburg sign test
pt stands on one foot. Look for contralateral pelvis dropping.
Apprehension test (shoulder)
Tests GHJ
Pt supine, lift arm in full range of flexion, assess apprehension of pt feeling as if joint is unstable. Perform flexion again but this time stabilise anterior shoulder.
Positive test: joint feels more stable when stabilised.
Empty can test
Tests GHJ (assesses lesions of supraspinatus muscle and tendon) raise arms to 90º flexion in the scapula plane, externally rotate 45º (as if emptying cans), apply downward pressure to arms.
Positive test: pain or weakness with resistance
Hawkins-kennedy test
Tests for impingement at GHJ
90º shoulder flexion, 90º elbow flexion then internal rotation of arm.
Positive test: pain when internally rotating arm.
Scarf test
Tests ACJ joint integrity
90º shoulder and elbow flexion, arm horizontally adducted so rests over contralateral shoulder like a scarf.
Positive test: if reproduces pts symptoms of pain.
Valgus/varus elbow stress test
Tests lateral collateral ligaments
Therapist places the patient’s elbow in slight flexion while palpating the humeroulnarjoint line.Apply a varus/valgus force to the elbow.Pain &/or laxity
Maudsley test
Tests lateral epicondylitis
While palpating the lateral epicondyle, the forearm is pronated and the elbow is slightly flexed. Extension of the 3rdfinger is resisted by the examiner. Positive if pain over the lateral epicondyle
Golfers elbow test
Tests medial epicondylitis
While palpating the medial epicondyle, the forearm is supinated and the elbow and wrist are extended. Positive if pain over the medial epicondyle.
Tinel’s sign test
Tests nerve entrapment
the examiner percusses the ulnar nerve in the cubital tunnel for 30-60 secs while the elbow is flexed. Positive if paraesthesia/numbness down the arm.
Mills test
Tests lateral epicondylitis
Pt seated and the clinician palpates the patient’s lateral epicondyle with one hand while pronating the patient’s forearm, fully flexing the wrist, the elbow extended. A production of pain in the area of the insertion at the lateral epicondyle indicates a positive test.
Finkelstein’s test
Tests for de Quervain’s
Pt closes fingers over thumb and slowly moves into ulnar deviation
Positive: reproduction of symptoms
Carpal tunnel compression test
Flex wrist to 60º and press between thenar and hypothenar eminence. Hold for 30 seconds.
Positive: reproduction of symptoms
Suspected scaphoid fracture test
Palpate scaphoid from anatomical snuffbox. Look for pain
