UE Special Tests

Question 1

Apprehension test for anterior shoulder dislocation

Answer 1

Supine with arm abducted to 90 deg
PT laterally rotates shoulder
+= look of apprehension or facial grimace before EROM

Question 2

Apprehension test for posterior shoulder dislocation

Answer 2

Supine with arm in 90 deg of flexion and medially rotated
PT applies posterior force through humerus
+= look of apprehension or facial grimace before end point

Question 3

Ludington’s Test

Answer 3

Sitting with hands clasped behind head with fingers interlocked
Asked to alternately contract and relax biceps
+= absence of movement at biceps tendon, may indicate rupture of long head of biceps

Question 4

Speed’s Test

Answer 4

Sitting or standing with elbow extended and forearm supinated
PT has one hand over bicipital groove and other on volar surface of forearm while resisting shoulder flexion
+= pain or tendernessin bicipital groove, may indicate biceps tendonitis

Question 5

Yergason’s Test

Answer 5

Sitting with 90 degrees of elbow flexion and forearm stabilized against thorax
PT places one hand on bicipital groove and other on pt. forearm while resisting supination and lateral rotation
+= pain or tenderness in bicipital groove, may indicate bicipital tendonities

Question 6

Drop Arm Test

Answer 6

Sitting or standing with arms elevated to 90 deg of shoulder abd
Pt. slowly lowers arms
+= pt unable to slowly lower arm(s) or presence of severe pain, may indicate tear in rotator cuff

Question 7

Hawkins-Kennedy Impingement Test

Answer 7

Sitting or standing with shoulder flexion at 90 deg and elbow flexed
PT applies medial rotation
+= pain, may indicate shoulder impingement involving supraspinatus tendon

Question 8

Neer Impingement Test

Answer 8

PT has one hand on posterior border of scap and other underneath pt. elbow
Arm is elevated through flexion
+= facial grimace or pain, may indicate shoulder impingement involving supraspinatus tendon

Question 9

Supraspinatus Test

Answer 9

Pt. arm placed in 90 deg of abd and 30 deg of horizontal add with thumb pointing downward
PT resists abduction
+= weakness or pain, may indicate tear of supraspinatus tendon, impingement, or suprascapular nerve involvement

Question 10

Adson maneuver

Answer 10

PT monitors radial pulse as pt. rotates head toward involved shoulder and extends head while PT laterally rotates and extends shoulder
+= absent or diminished radial pulse, may indicate thoracic outlet syndrome

Question 11

Allen Test

Answer 11

Arm in 90 deg abd, lateral rotation, and elbow flexed
Pt. rotates head away from involved shoulder as PT monitors radial pulse
+= absent or diminished pulse, may indicate thoracic outlet syndrome

Question 12

Costoclavicular Syndrome Test

Answer 12

While sitting, PT monitors radial pulse and places pt into military posture
+= absent or diminished radial pulse, may indicate thoracic outlet syndrome via compression of subclavian artery b/w 1st rib and clavicle

Question 13

Roos Test

Answer 13

Arms in 90 deg of abd, lateral rotation, and elbow flexion
Pt opens and closes hands for 3 min
+= inability to maintain test position, weakness of arms, sensory loss or ischemic pain, may indicate thoracic outlet syndrome

Question 14

Wright (hyperabduction) Test

Answer 14

While sitting or supine, PT moves pt arm overhead in the frontal plane while monitoring radial pulse
+= absent or diminished radial pulse, may indicate compression of costoclavicular space

Question 15

Glenoid Labrum Test

Answer 15

Supine with PT placing one hand on posterior aspect of humeral head while other hand stabilizes humerus proximal to elbow
PT passively abducts and laterally rotates arm over head while applying anterior force
+= clunk or grinding sound, may indicate glenoid labrum tear

Question 16

ULLT Test: Radial nerve

Answer 16

Shoulder depression with 10 deg abduction
Elbow extension
Forearm pronation
Wrist flexion & ulnar deviation
Finger & thumb flexion
Shoulder medial rotation

Question 17

ULLT Test: Ulnar nerve

Answer 17

Shoulder depression 10-90 deg of shoulder abduction
Elbow flexion
Forearm supination
Wrist extension & radial deviation
Finger and thumb extension
Shoulder lateral rotation

Question 18

ULLT Test: Median nerve, anterior interosseous nerve

Answer 18

Shoulder depression with 100 deg abduction
Elbow extension
Forearm supination
Wrist extension
Finger & thumb extension

Question 19

ULLT Test: median nerve, axillary nerve, musculocutaneous nerve

Answer 19

Shoulder depression with 10 deg abduction
Elbow extension
Forearm supination
Wrist extension
Finger & thumb extension
Shoulder lateral rotation

Question 20

Varus stress Test

Answer 20

Sitting with elbow flexed 20-30 deg
PT has one hand on proximal elbow and other proximal to pt wrist while applying varus force
+= increased laxity in lateral collateral ligament, apprehension or pain, may indicate tear of lateral collateral ligament

Question 21

Valgus stress Test

Answer 21

Sitting with elbow flexed 20-30 deg
PT has one hand on proximal elbow and other proximal to pt wrist while applying valgus force
+= increased laxity in medial collateral ligament, apprehension or pain, may indicate tear of medial collateral ligament

Question 22

Cozen’s Test

Answer 22

Sitting with elbow in slight flexion
PT stabilizes elbow while palpating lateral epicondyle
Pt fights resistance while making a fist, pronating forearm, extending wrist and radial deviation
+= pain @ lateral epicondyle or muscle weakness, may indicate lateral epicondylitis

Question 23

Lateral epicondylitis Test

Answer 23

PT stabilizes elbow with one hand and places other on dorsal aspect of pt hand distal to PIP
Pt extends middle finger against resistance
+= pain @ lateral epicondyle, may indicate lateral epicondylitis

Question 24

Medial epicondylitis Test

Answer 24

PT palpates medial epicondyle and supinates pt forearm and extends wrist and elbow
+= pain @ medial epicondyle, may indicate medial epicondylitis

Question 25

Mill’s Test

Answer 25

PT palpates lateral epicondyle, pronates forearm, flexes wrist, and extends elbow
+= pain @ lateral epicondyle, may indicate lateral epicondylitis

Question 26

Ulnar collateral ligament instability Test

Answer 26

PT holds thumb in extension while applying valgus force @ MCP of thumb
+= excessive valgus movement, may indicate tear of ulnar collateral ligamentand accessory collateral ligaments
Gamekeepers or skiers thumb

Question 27

Allen Test

Answer 27

Pt asked to open and close hand several times and then keep hand closed
PT compresses radial and ulnar arteries then pt relaxes hand and PT releases pressure on one artery while observing color of hands and fingers
+= delayed or absent flushing of radial and ulnar half of hand, may indicate occlusion in radial or radial artery

Question 28

Bunnel-Littler Test

Answer 28

MCP joint held into slight extension as PT moves PIP into flexion
If PIP is unable to flex with MCP extension, may be tight intrinsic muscle or capsular tightness
IF PIP fully flexes with MCP in slight flexion, may be intrinsic muscle tightness WITHOUT capsular tightness

Question 29

Tight retinacular ligament Test

Answer 29

PIP is held in neutral while PT tries to flex DIP
If unable to flex DIP, retinacular ligaments or capsule may be tight
If able to flex DIP with PIP flexion, may be tight retinacular ligaments and capsule may be normal

Question 30

Froment’s Sign

Answer 30

Pt holds piece of paper b/w thumb and index finger as PT tries to pull away
+= pt flexes distal phalanx of thumb due to adductor pollicis muscle paralysis
If pt hyperextends MCP of thumb= Jeanne’s sign
Both may indicate ulnar nerve compromise or paralysis

Question 31

Phalen’s Test

Answer 31

Pt maximally flexes wrist and holds them together for 60s
+= tingling in thumb, index finger, middle finger, and lateral half of ring finger, may indicate carpal tunnel syndrome due to median nerve compression

Question 32

Tinel’s Sign

Answer 32

Elbow in slight flexion as PT taps with index finger b/w medial epicondyle and olecranon process
+= tingling in ulnar nerve distribution, may indicate ulnar nerve compression or compromise

Question 33

Finkelstein Test

Answer 33

Pt makes fist while thumb tucked inside fingers
PT stabilizes forearm and ulnarly deviates wrist
+= pain over abductor pollicis longus and extensor pollicis brevis tendon, may indicate tenosynovitis in thumb aka deQuervain’s disease

Question 34

Grind test

Answer 34

PT stabilizes pt hand and grasps along thumb at MCOP and applies compression and rotation
+= pain, may indicate degenerative joint disease

Question 35

Murphy Sign

Answer 35

Pt asked to make a fist

+= pt 3rd MCP remains level with 2nd and 4th MCPs, may indicate dislocated lunate

Question 36

Tinel’s Sign

Answer 36

Pt taps over volar aspect of pt wrist
+= tingling in thumb, index finger, middle finger, and lateral half of ring finger, may indicate carpal tunnel syndrome due to median nerve compression