Special Tests - Knee Flashcards
What is the Stroke Test?
Fluid displacement test
How to perform the Stroke Test?
Stroke upwards 3 Tim es from medial knee
then stroke downward once on lateral side
What is a positive stroke test?
Wave of fluid moves into medial joint compartment on the downward stroke
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
What is the fluid displacement test?
Squeezing the fluid out of the supra patella pouch to detect effusion
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
What is a positive fluid displacement test?
Distension of the opposite side of the knee joint when stroking
What is the patella tap test?
Large effusion in the supra patella pouch
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
What is the Apley Grind Test?
Testing for tear of the posterior horn of the meniscus
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
Positive Apley grind test?
Reproduction of symptoms
Pain or clicking
What is the Apley Distraction test?
Testing for a ligament tear
How to perform Apley Distraction?
Pt prone ly
My knee on back of pt thigh
Apply upward distraction force with medial and lateral rotation
What is the Thessaly Test?
Test for tears of medial or lateral meniscus
- by applying axial load and rotation
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
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
