Tests for Diagnosing Pathology Flashcards
Ligament Instability: testing for sprained medial (ulnar) collateral ligament
Valgus Stress Test
Ligament Instability: testing for sprained lateral (radial) collateral ligament
Varus Stress Test
Ulnar nerve entrapment (cubital tunnel syndrome)
Tinel Test
Medial Epicondylitis
Golfer’s Elbow Test
Lateral Epicondylitis
Tennis Elbow Test (Cozen’s test)
Anterior Interosseous Nerve Neuropathy
“OK” Sign
Carpal tunnel syndrome (CTS)
Tinel’s Sign
Phalen’s Sign
DeQuervain’s Tenosynovitis
Finkelstein Test
Glenohumeral instability
+: patient is apprehensive of repeat dislocation
Apprehension Test
Glenohumeral instability
+: indentation appears in area beneath acromion
Sulcus Sign
Unstable bicipital tendon
+: pain and/or tendon subluxation out of groove
Patient’s arm at side with elbow flexed 90 deg. Physician uses one hand to palpate bicipital groove and monitors there, while the other hand grasps the patient’s wrist. Pt supinates and externally rotates against resistance.
Yergason’s Test
Bicipital tendonitis of longhead of biceps brachii
+: pain in bicipital groove
Patient’s arm flexed (50-90 deg) at the shoulder with hand supinated. Slightly flex pt’s elbow. Resist at forearm while pt flexes shoulder
Speed’s Test
Rotator cuff pathology (specifically supraspinatus)
+: Pain or weakness
Flex pt’s shoulders to 90 deg. while horizontally abduction to 45 deg. Then internally rotate both arms so thumbs are pointing down (emptying can). Press down on forearms while pt resists.
Empty Can Test
Full thickness tear of supraspinatus
+: Arm will drop, or gentle tap on wrist will cause arm to drop
Drop-arm Test
Indicates subacromial impingement and/or rotator cuff injury
+: Pain is elicited within 60 -120 degrees of shoulder abduction
Painful Arc Test
Subacromial bursa or rotator cuff impingement
+: pain
Stabilize pt’s shoulder. With forearm pronated passively flex shoulder to fully flexed position
Neer Impingement Test
Rotator cuff or subacromial bursa impingement
+: pain
Flex shoulder to 90 deg, flex elbow to 90 deg, and passively rotate the humerus into internal rotation. This opposes rotator cuff against coracoacromial ligament and acromion
Hawkins Test
Subscapularis weakness
+: weakness (inability to resist)
Lift Off Test
AC joint pathology
+: pain in AC joint with end range adduction
Physician PASSIVELY adducts patient’s arm across their chest and rests pt’s hand on their opposite shoulder
Cross Arm Test
Ulnar nerve entrapment
“Handlebar Palsy”
Extensor tendon injury at DIP
Mallet Finger
Inflammation and narrowing of flexor tendon sheath
Trigger Finger
Avulsion of flexor digitorum profundus from fingertip
Jersey Finger
Abnormal connective tissue thickening in the palmar fascia
Dupuytren’s Contracture
Fracture of the proximal ulna; dislocation of the radial head
Monteggia Fracture
Fracture of the distal radius; dislocation of the ulna
Galeazzi Fracture
Labrum, ligamentum teres, and articular surfaces
Central Compartment
Femoral neck, synovial lining
Peripheral Compartment
Gluteus medius, minimus, piriformis, IT band, trochanteric bursae
Lateral Compartment
Iliopsoas insertion, iliopsoas bursae
Anterior Compartment
Central or peripheral compartment pathology
+: pain
Log Roll
Labral pathology
Patient characteristically points to the source of pain with two fingers or cups just above the trochanter with the thumb and index finger
C-sign
Labral or cartilaginous pathology
+: pain
Flex pt’s knee and hip to 90 deg, load into femur towards the hip bone
Labral Loading
Labral or cartilaginous pathology
+: improvement of pain
Distract pt’s femur away from hip bone
Labral Distraction
Labral or articular cartilage pathology
+: pain
Flex and externally rotate pt’s hip. Load into socket and articulate through annular range of motion
Scour
Labral pathology
+: Anterior subluxation of hip or apprehension/pain
Pt’s hip flexed, abducted, externally rotated. Physician induces further external rotation by applying a posterior force at the knee
Apprehension FABER (1/3)
Rectus femoris contraction
+: knee flexion <90 deg
Pt supine. One hip is flexed up to the chest. The other leg is bent over the edge of the table
Rectus Femoris Test
Trochanteric Bursitis (lateral compartment)
+: pt withdraws or “jumps” with pressure
Jump Sign
IT band contracture
+: pain over lateral leg, especially at >15 deg.
Positive signs usually occur btwn 30-60 deg if cause is lumbosacral radiculopathy and/or sciatic neuropathy
Positive signs at >70 deg is more likely mechanical low back pain due to muscle strain or joint disease
Straight Leg Raise Test
Piriformis spasm or pathology
+: pain over posterior aspect of greater trochanter
Pt supine with hip and knee flexedd, one ankle crossed over contralateral knee. Pt abducts against resistance
Piriformis Test
Gluteus medius pathology
+: pain or weakness
pt’s hip is flexed, abducted, and externally rotated. Physician braces contralateral ASIS, pt externally rotates/abducts against resistance
Patrick’s FABER (2/3)
Iliopsoas insufficiency or pathology
+: anterior or medial groin pain/weakness
Pt’s hip flexed, abducted, and externally rotated. Physician braces contralateral ASIS. Pt internally rotates/adducts against resistance
Patrick’s FABER (3/3)
Hip flexor contraction
+: inability to fully extend, or extended leg raises off table
Thomas Test
Possible meniscal injury, collateral ligament injury, or both
+: pain with rotation and/or compression
Pt prone with knee flexed to 90 deg. Downward force on foot to provide a compressive force on the meniscus, while rotating the foot internally and externally
Apley’s Grind Test- Compression test
Possible collateral ligament damage
+: pain with distraction and rotation
Pt in same position as for the apley compression. Physician stabilizes thigh, then applies upward traction to leg while rotating it (traction reduces meniscal pressure, but increases ligamentous strain)
Apley’s Grind Test -Distraction test
