Special Tests - Knee Flashcards by Millie Dean

What is the Stroke Test?

Fluid displacement test

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How to perform the Stroke Test?

Stroke upwards 3 Tim es from medial knee

then stroke downward once on lateral side

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What is a positive stroke test?

Wave of fluid moves into medial joint compartment on the downward stroke

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What is happening during the stroke test?

Moving the fluid up into the supra patella pouch (within the joint capsule)

Then reducing the space in the Jc on the downstroke to see if the effusion is large

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What is the fluid displacement test?

Squeezing the fluid out of the supra patella pouch to detect effusion

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How to perform the fluid displacement test?

cup around distal thigh and apply downwards pressure - keep hand where it is and then stroke the medial side of the joint , then the lateral side of the joint

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What is a positive fluid displacement test?

Distension of the opposite side of the knee joint when stroking

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What is the patella tap test?

Large effusion in the supra patella pouch

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How to perform the patella tap test?

cup distal thigh and apply downwards pressure - maintain position and apply downward pressure with two fingers not he patella

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What is the Apley Grind Test?

Testing for tear of the posterior horn of the meniscus

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How to perform the Apley Grind?

Pt prone ly

My knee on back of pt thigh

Apply towards pressure on foot and grind medially or laterally

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Positive Apley grind test?

Reproduction of symptoms

Pain or clicking

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What is the Apley Distraction test?

Testing for a ligament tear

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How to perform Apley Distraction?

Pt prone ly

My knee on back of pt thigh

Apply upward distraction force with medial and lateral rotation

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What is the Thessaly Test?

Test for tears of medial or lateral meniscus

- by applying axial load and rotation

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How to perform the Thessaly test?

Standing, non-test leg flexed -

Test side knee bent to 20, rotate on the tibia three times both ways

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What is a positive test of Thessaly’s?

reproduction of symptoms at the medial or lateral joint line

(AKP not positive)
Must be >4 weeks post injury

What are you testing during the valgus stress test of the knee?

Testing integrity of the MCL

What is a positive test of the valgus stress test?

pain, laxity or gapping

How to perform the valgus stress test?

Upper hand on outer thigh

Lower hand on medial ankle

Apply pressure through lower hand to stress the medial side of the knee

what is the varus stress test?

A test for LCL integrity

How to perform the varus stress test?

Upper hand on medial thigh

Lower hand on outer ankle

Apply pressure through outer ankle to stress medial side of the knee

What is a positive varus stress test?

PAin, Laxity or gapping

What is Lachmanns test for?

ACL sprain or rupture

What is a positive lachmans test?

Pain or excessive anterior translation

How to perform LAchmanns test?

Pillow under knee Use lower hand to cup around top of back of calf (thumb on tibial tuberosity) Use upper hand to stabilise femur Pull tibia forwards

What is a posterior draw test for?

PCL sprain or rupture

What is a positive posterior draw test?

Laxity or excessive posterior translation

How to perform the posterior draw test?

Both knees bent to 70 degrees - apply force down tibia and observe for posterior draw

What is McMurrays test for?

Integrity of the medial and lateral meniscus

How to perform McMurrays test?

Lower hand on ankle Upper hand over knee joint bring knee into full flexion - checking for pain or clicking For medial meniscus - put foot into eversion, slowly lower leg into extension For lateral meniscus - put foot into inversion, slowly lower leg into extension

What is a positive McMurrays test?

Pain, apprehension or clicking In conduction with giving way, effusion or instability symptoms

What is Clark's sign test?

Patello-femoral pain syndrome - forcing the normal movement of the patella through the femoral condyles

What is a positive Clark's Sign test?

Apprehension or refusal to contract quads Pain

How to perform the Clark's test?

Web of hand down anterior thigh to hold patella down - then ask patient to contract quads

What is the patellofemoral compression test for?

Testing for abnormal patella tracking - Patellofemoral pain syndrome

What is a positive patellofemoral compression test?

Pain or discomfort

How to perform the patellofemoral compression test?

compress the patella while the patient flexes and extends their leg within a 35 degree range

What is the patella apprehension test for?

Testing for patellofemoral pain syndrome

how to perform the patella apprehension test?

Pillow under knee Apply lateral glide to the patella

What is a positive patella apprehension test?

Apprehension or active contraction of quads to try and reduce the feeling of instability