Special Tests Flashcards
Test(s) for Lateral Epicondylitis (Tennis Elbow)?
Cozen’s Test
Wringing Test
Maudsley’s Test
Mill’s Test
Describe how you would carry out Cozen’s Test and what a positive diagnoses indicates:
Lateral Epicondylitis (Tennis Elbow).
Patient seated with elbow extended and pronated (palm down on the plinth), then put into radial deviation. The examiner stabilises the elbow and asks the patient to perform resisted wrist extension.
+ve = Reproduction of pain over lateral epicondyle / extensor compartment during resisted WE.
Test(s) for potential # at the elbow ?
Elbow Extension sign
Test(s) for Cubital Tunnel Syndrome at the elbow ?
Elbow Flexion Test
Test(s) for the Lateral Collateral Ligament?
Varus Stress Test
Describe how you would carry out the Wringing Test and what a positive diagnoses indicates:
Lateral Epicondylitis (Tennis Elbow).
Ask the patient to grasp an object (e.g. a towel) with both hands, slight bend in the elbows and simulate a wringing action by twisting hands in opposite directions
+ve = Reproduction of pain over lateral epicondyle / extensor compartment.
Describe how you would carry out the Modified Milking Manoeuvre Test and what a positive diagnoses indicates:
Ulnar (A.K.A Medial) Collateral Ligament.
Patient seated with elbow supinated and flexed to 90*. The examiner stabilises the elbow joint then pulls on the patients thumb, applying a valgus force to the elbow.
+ve = pain, instability or apprehension along the medial aspect of the elbow.
can be done in multiple degrees of flexion to test ligament further
Test(s) for Medial Epicondylitis (Golfers Elbow)?
Medial Epicondylitis Test
Reverse Mills Test
Resisted Pronation Test
Test(s) for the Ulnar Collateral Ligament (A.K.A Medial Collateral Ligament)?
Valgus Stress Test
Moving Valgus Stress Test
Modified Milking Manoeuvre
Describe how you would carry out the Elbow Extension Sign Test and what a positive diagnoses indicates:
Potential Elbow #.
Patient standing or sitting ensure shoulder is in a neutral position and arm relaxed by side. Ask the patient to fully extend both elbows simultaneously.
+ve = unable to fully extend compared to contralateral side.
Describe how you would carry out the Elbow Flexion Test and what a positive diagnoses indicates:
Cubital Tunnel Syndrome
Patient seated or standing, ask them to fully flex at the elbow and extend at the wrist joint then hold this position for 2-3mins.
+ve = pain or neuro symptoms in ulnar nerve distribution (little finger and ulnar half of ring finger).
Describe how you would carry out the Varus Stress Test and what a positive diagnoses indicates:
Lateral Collateral Ligament Integrity.
Patient supine, sitting or standing. Place the elbow in ~20* flexion then stabilise the distal humerus and apply a varus stress to the elbow with the other (lower arm toward the body).
+ve = Pain or excessive laxity.
can be done in multiple degrees of flexion to test ligament further
Describe how you would carry out Maudsley’s Test and what a positive diagnoses indicates:
Lateral Epicondylitis (Tennis Elbow).
Patient sits forearm resting on a table, elbow extended and pronated. Examiner resists extension of the middle finger whilst palpating the lateral epicondyle.
+ve = Pain or tenderness over the lateral epicondyle / extensor compartment.
Describe how you would carry out the Medial Epicondylitis Test and what a positive diagnoses indicates:
Medial Epicondylitis (Golfer’s Elbow)
Patient sits with elbow extended and forearm supinated (palm up resting on plinth), examiner fixates the elbow and resists wrist flexion.
+ve = pain recreated over medial epicondyle or flexor compartment.
Describe how you would carry out the Valgus Stress Test and what a positive diagnoses indicates:
Ulnar / Medial Collateral Ligament Integrity.
Patient supine, sitting or standing. Place the elbow in ~20* flexion then stabilise the distal humerus and apply a valgus stress to the elbow with the other (lower arm away from body).
+ve = Pain or excessive laxity.
can be done in multiple degrees of flexion to test ligament further
Describe how you would carry out Reverse Mill’s Test and what a positive diagnoses indicates:
Medial Epicondylitis (Golfer’s Elbow)
The examiner passively supinates and extends the wrist, then moves the patient passively through elbow flexion & extension.
+ve = pain recreated over medial epicondyle or flexor compartment.
Describe how you would carry out Resisted Pronation Test and what a positive diagnoses indicates:
Medial Epicondylitis (Golfer’s Elbow)
Patient sits or stands with elbow flexed at 90* and forearm in neutral, the examiner stabilises the elbow with one hand and with the other resists pronation.
+ve = pain recreated over medial epicondyle or flexor compartment.
Describe how you would carry out the Moving Valgus Stress Test and what a positive diagnoses indicates:
Ulnar / Medial Collateral Ligament Integrity.
Abduct the shoulder to 90* and full flexion (front bicep pose). Then stabilise the elbow at the distal humerus and apply a valgus force by pulling lower arm backwards, then extend the elbow keeping this valgus stress force throughout.
+ve = Pain or excessive laxity.
Describe how you would carry out Mill’s Test and what a positive diagnoses indicates:
Lateral Epicondylitis (Tennis Elbow).
The examiner passively pronated and flexes the wrist, then moves the patient passively through elbow flexion & extension.
+ve = Reproduction of pain over lateral epicondyle / extensor compartment.
Describe how you would carry out Wartenberg’s Sign Test and what a positive diagnoses indicates:
Ulnar Neuropathy
The patient sits with their hand resting palm down on a surface. The examiner passively abducts each of the 5 digits then asks the patient to bring all their digits back together.
+ve = inability to adduct the Pinky finger to the remainder of the hand.
Test(s) for Ulnar Neuropathy?
Waterberg’s Sign
