Special Tests - Lower Extremities

Question 1

Ely’s test

Answer 1

Rectus femoris tightness/contracture

Question 2

Ober’s test

Answer 2

ITB or TFL contracture/tightness

Question 3

Piriformis test

Answer 3

Sidelying with hip flexed to 60 deg. One hand on pelvis on other on knee. Stabilize pelvis and apply downward force on knee. Positive test is pain or tightness and may indicate piriformis tightness or compression on the sciatic nerve from the piriformis.

Question 4

Tripod sign

Answer 4

Pt sitting with knees at 90 deg with legs hanging off of table. PT passively extends one knee. Positive test indicated by tightness in hamstrings or extension of the trunk.

Question 5

90-90 straight leg raise

Answer 5

Positive if knee is in 20 degrees of flexion or more

Question 6

Barlow’s test

Answer 6

Pediatric test. Supine with hips and knees flexed to 90 deg. Stabilize femur and pelvis with one hand while other hand moves leg into adduction and provides posterior force. Positive test indicated by click or clunk, with hip dislocating.

Question 7

Ortolani’s test

Answer 7

Pediatric test. Supine with hips and knees flexed to 90 deg. Stabilize femur and pelvis with one hand while other hand moves leg into abduction and provides anterior force. Positive test indicated by click or clunk, with hip reducing.

Question 8

Anterior labral tear test

Answer 8

Passively bring hip into flexion, ER, and abduction. Move hip into extension, IR, and adduction. Positive if pain or click. Can also indicate illiopsoas tendonitis or anterior-superior impingement.

Question 9

Craig’s test

Answer 9

Prone with knee bent to 90 deg. Find where greater trochanter is parallel with table. Normal anteversion is 8-15 deg for an adult.

Question 10

Patrick’s test (FABER)

Answer 10

Pain or decreased ROM may indicate iliopsoas, SI, or hip joint abnormalities.

Question 11

Quadrant scouring test

Answer 11

Positive if grinding, catching, or crepitus in hip and may indicate arthritis, avascular necrosis, or osteochondral defect.

Question 12

Lateral pivot shift test

Answer 12

Medially rotate tibia and applies valgus force while knee is flexed. Palpable shift or clunk at 20 to 40 deg flexion indicates anterolateral rotary instability. Shift or clunk results from reduction of tibia on femur.

Question 13

Slocum test

Answer 13

Pt in supine with hips in 45 and knees in 30 flexion. Rotate foot 30 deg medially and pull tibia forward. Positive if if movement of the tibia occurs primarily on the lateral side and may indicate anterolateral instability. Can also test anteromedial instability by rotating the pt foot 15 degrees laterally and doing the same.

Question 14

Bounce home test

Answer 14

Pt in supine, PT grasps the pt’s heel and maximally flexes the knee. Extend knee passively. Positive if incomplete extension or rubbery end-feel and may indicate meniscal lesion.

Question 15

Brush test

Answer 15

PT places one hand below joint line on medial surface of patella and strokes proximally. The other hand strokes down the lateral surface of the patella. Positive test indicated by a wave of fluid just below the medial distal border of the patella and indicates effusion in the knee.

Question 16

Patellar tap test

Answer 16

Knee positioned in flexion or extension at point of discomfort. Tap over patella. Positive for joint effusion if patella appears to be floating.

Question 17

Clarke’s sign

Answer 17

PT applies pressure distally to superior patella. Pt then attempts to contract quads. Positive if failure to complete contraction without pain and may indicate patellofemoral dysfunction.

Question 18

Hughston’s plica test

Answer 18

PT flexes knee and medially rotates tibia while other hand moves patella medially. Positive if popping sound over medial plica while knee is passively flexed and extended. May indicate abnormal or irritated plica.

Question 19

Noble compression test

Answer 19

Supine with knee flexed to 90 deg. One thumb on lateral epicondyle of femur and other hand around pt ankle. Pt slowly extends knee. Positive if pain over lateral femoral epicondyle at 30 deg of knee flexion and may indicate ITB friction syndrome.

Question 20

Patellar apprehension test

Answer 20

Moves patella laterally. Positive if look of apprehension or attempt to contract quads to avoid subluxation and may indicate patella subluxation or dislocation.

Question 21

Lateral rotation stress test (Kleiger test)

Answer 21

Pt sitting at edge of table. PT stabilizes distal leg and uses other hand to ER the foot. If pain over anterior or posterior tibiofibular ligaments and interosseous membrane, then positive for high ankle sprain. If pain medially and talus shifts away from medial malleolus, then positive for deltoid ligament tear.

Question 22

Talar tilt test

Answer 22

Sidelying with knee flexed to 90 deg. Therapist stabilizes distal tibia and grasps the talus with other hand, moving it into abduction and adduction. Positive if there is excessive adduction and may indicate calcaneofibular ligament sprain.

Question 23

Thompson test

Answer 23

Squeeze gastroc and soleus. Positive if absence of PF and may indicate rupture Achilles tendon.

Question 24

Tibial torsion test

Answer 24

Normal lateral torsion of tibia is 12-18 degrees in an adult.

Question 25

Vertebral artery test

Answer 25

In supine, sidebend, rotate, and extend head. Positive if dizziness, nystagmus, slurred speech, or loss of consciousness and may be indicative of compression of vertebral artery.

Question 26

Gapping test

Answer 26

PT applies downward and lateral force to both ASIS. Positive if pain in SIJ, gluteus, or posterior leg and may indicate sprain of anterior SI ligaments.

Question 27

SIJ Stress test

Answer 27

Apply downward and lateral force to pelvis. Positive if unilateral SIJ or gluteal pain and may indicate SIJ dysfunction.

Question 28

Standing or Sitting flexion test

Answer 28

Pt in sitting or standing and bends forward with PT’s thumbs on PSIS. Positive if one PSIS moves farther cranially and may indicate articular restriction.