special tests

Question 1

Patellar ballottement test

Answer 1

knee
Patient supine. Quickly push patella posteriorly with two or three fingers.- Patella bounces off the trochlea with a distinct impact

Question 2

Straight leg test

Answer 2

lumbar spine
Patient supine, knee fully extended, ankle in neutral dorsiflexion. Passively flex hip while maintaining knee extension to the point where discomfort or paresthesia is experienced in back or lower limb. Various sensitizing maneuvers such as ankle DF or cervical spine flexion may then be added
Diiscomfort or tightness restricts motion, especially in comparison to opposite side.

Question 3

Empty Can sign-

Answer 3

Shoulder
Patient’s arm is positioned in scapular plane and internal rotation for empty can or external rotation for full can at approximately 90 degreesof flexion. Manual resistance is applied by clinician toward floor.- Supraspinatus tear if discomfort, weakness

Question 4

Hornblower’s Sign

Answer 4

shoulder
Patient seated. Clinician places patient’s arm in 90 degrees of scaption and asks patient to externally rotate against resistance.- Infraspinatus or teres minor tear if unable to ER shoulder.

Question 5

Lift off test

Answer 5

shoulder
Patient seated with arm internally rotated so the back of the hand restson the low back. Patient is asked to lift the hand away from the back.- Subscapularis weakness/subacromial impingement if unable.

Question 6

Yergason’s sign

Answer 6

• shoulder
  Patient’s elbow flexed to 90 degrees with forearm pronation. Patient is then instructed to actively supinate forearm against resistance.- Subacromial impingement if discomfort

Question 7

Drop arm test-

Answer 7

Shoulder
Clinician passively abducts patient’s arm to 90 degrees and asks patient to hold and the slowly lower arm.- Positive for RC weakness or tear if patient cannot hold or slowly lower arm in a controlled manner.

Question 8

Ankle impingement sign-

Answer 8

ankle
patient seated. Clinician grasps Calcaneus with one hand and uses other hand to grasp forefoot and bring it into plantarflexion. Clinician places pressure with thumb over anterolateral ankle while foot is brought from plantar to dorsiflexion under thumb pressure.- Anterolateral ankle impingement if discomfort is felt under thumb that is greater in dorsiflexion than plantar flexion.

Question 9

Lachman’s test

Answer 9

knee
Patient supine. Knee joint flexed between 10-20 degrees and femur is stabilized with one hand while other hand translates tibia forward.- Lack of end feel for tibial translation or subluxation is positive for ACL deficiency.

Question 10

Pivot shift test-

Answer 10

knee
Supine with knee in 10-20 degrees of flexion and tibia rotated internally while clinician applies valgus force.- Positive for ACL deficiency if lateral tibial plateau subluxes anteriorly

Question 11

McMurrray’s test

Answer 11

Knee
Supine, clinician brings the leg from extension to 90 degrees flexion with foot held in internal then external rotation.- Positive for meniscal tear there is a palpable clunk.

Question 12

Ankle anterior drawer

Answer 12

ankle
Supine clinician maintains ankle in 10-15 degrees of plantarflexion while drawing heel and gliding joint gently forward.- Positive for ATFL tear if talus rotates out of the ankle mortise anteriorly.

Question 13

Talar tilt-

Answer 13

ankle
Sitting with ankle relaxed. Clinician gently inverts ankle joint to end range and compares to opposite side.- Greater inversion or lack of end feel indicate potential calcaneofibularligament compromise.

Question 14

Varus stress test-

Answer 14

To determine the presence of a lateral collateral ligament tear of the elbow.

Test Position: Seated

Performing the Test: The affected elbow is placed in approximately 20 degrees of flexion with the humerus in full medial rotation while palpating the lateral joint line. The therapist then applies a varus force to the elbow. If the patient experiences pain or excessive gapping compared to the contralateral side the test is considered positive.

Question 15

Patrick’s/FABER’s test-

Answer 15

Supine.

Performing the Test: The patient’s tested leg is placed in a “figure-4” position, where the knee is flexed and the ankle is placed on the opposite knee. The hip is placed in flexion, abduction, and external rotation (which is where the name FABER comes from). The examiner applies a posteriorly-directed force against the medial knee of the bent leg towards the table top. A positive test occurs when groin pain or buttock pain is produced. Due to forces going through the hip joint as well, the patient may experience pain if pathology is located in the hip as well.