Special Tests Flashcards
What are the Ottawa Ankle Rules?
Clinical guidelines to determine whether an XR is required for an ankle or foot injury to rule out fracture.
Describe how you would carry out the Anterior Drawer Test and what a positive diagnoses indicates:
LCL Injury especially the ATFL ligament.
Patient seated foot relaxed, apply a gentle P-A, pushing tibia backwards and pulling back of the heel forwards.
+ve = Excessive anterior translation or pain.
Describe how you would carry out the Kleiger’s Test and what a positive diagnoses indicates:
Syndesmosis & Deltoid Ligs.
Patient seated knee hanging 90* and ankle relaxed. Stabilise the tib/fib and then passively externally rotate the foot with full dorsiflexion.
+ve = pain at site of interosseous membrane.
Test(s) for LCL Injury?
Anterior Drawer Test
Describe how you would carry out the Figure of Eight Test and what a positive diagnoses indicates:
Swelling at the Ankle.
Patient seated with foot resting over edge of plinth, then measure with a tape around 4 standard landmarks:
1) Between Tib Ant Tendon and Lateral Malleolus.
2) Navicular Tuberosity
3) Base of 5th Metatarsal
4) Inferior tip of Medial Malleolus
+ve = cm difference between ankles.
Describe how you would carry out the Silfverskiöld Test and what a positive diagnoses indicates:
Contracture of Ankle plantarflexors.
Patient lies supine and examiner passively dorsiflexes ankle. This is repeated with full knee extension then at 90* knee flexion.
Interpretation:
DF improves with KF = Isolated Gastrocnemius Contracture.
DF limited in KE & KF = Achilles Tendon Contracture.
Describe how you would carry out the Fibular Compression Test and what a positive diagnoses indicates:
Syndesmosis Injury.
Patient seated with leg extended & relaxed. Place both hands on the distal tib/fib and apply a gentle squeezing pressure.
+ve = pain in the distal tibiofibular region.
Describe how you would carry out the Eversion Stress Test and what a positive diagnoses indicates:
Deltoid Ligament Integrity.
Patient seated with foot relaxed, stabilise the lower leg then apply an abduction / eversion force on the ankle
+ve = Excessive laxity or pain along medial ligaments.
Describe how you would carry out the Inversion Stress Test and what a positive diagnoses indicates:
Lateral Ligament Integrity.
Patient seated with foot relaxed, stabilise the lower leg then apply an adduction/ inversion force on the ankle
+ve = Excessive laxity or pain along lateral ligaments.
What are the Ottawa Rules for a foot Injury?
Pain in midfoot zone WITH:
- Bone tenderness at 5th metatarsal or navicular bone
- Inability to weight bear 4 steps.
Test(s) for Syndesmosis Injury?
Fibular Compression Test
Kleiger’s Test (also tests Deltoid Ligaments)
Test(s) for Deltoid Ligament Injury?
Eversion Stress Test.
Kleiger’s Test (also tests Syndesmosis)
Test(s) for Achilles Tendon Rupture?
Simmons Test
Describe how you would carry out the Impingement Test and what a positive diagnoses indicates:
Ankle Impingement.
Patient seated with relaxed foot, clinician stabilises the heel then applies firm pressure with thumb onto anterolateral aspect of ankle joint. Then passively move into dorsi & plantarflexion.
Anterior Impingement = Dorsiflexion pain
Posterior Impingement = Plantarflexion Pain
Test(s) for Swelling at the Ankle Injury?
Figure of Eight
