UE Special Tests Flashcards
Elbow - valgus stress test
Pht
- Facing pt
- Proximal hand: on lateral aspect of distal humerus or joint line
- Distal hand: hold distal F/A (in full supination)
- Tested at different angle of elbow extension-flexion
- Pht apply a valgus stress by turning your torso
Findings:
- Gr I sprain: No gap, normal EF & pain
- Gr II sprain: Gap, normal EF & pain
- Gr III sprain: Gap, soft EF with more or less pain
Position:
-Pt supine, Pht facing pt (Hold 5 sec)
Elbow - varus stress test
Pht
- Proximal hand: on medial joint line or distal humerus
- Distal hand: hold distal F/A (in full supination)
- Tested at different position of elbow extension & flexion
- Pht apply a varus stress by turning your torso
Findings:
- Gr I sprain: No gap, normal EF & pain
- Gr II sprain: Gap, normal EF & pain
- Gr III sprain: Gap, soft EF with more or less pain
Position:
-Pt supine, Pht facing pt (Hold 5 sec)
Elbow - lateral epicondylitis (passive test)
Elbow - lateral epicondylitis (active test)
Elbow - lateral epicondylitis (differential tissue test)
Elbow - medial epicondylitis (passive and active test)
wrist - distal ru ligament stress test
Findings:
Gr I sprain: Strong normal EF & pain
Gr II sprain: Solid Firm EF but much further into range & P
Gr III sprain: Sluggish or NO EF with more or less pain
Position:
- Pt seated
- Pht facing pt, look for NZ, EF & pain; hold 5sec
wrist - RCL and LCL ligament stress test
Wrist collateral ligaments
Pt: wrist in extension (just out of CPP)
Pht:
- One hand: stabilize distal radius/ulna
- One hand: grasps proximal & distal rows of carpal bones
Findings:
Gr I sprain: Strong normal EF & pain
Gr II sprain: Solid Firm EF but much further into range & P
Gr III sprain: Sluggish or NO EF with more or less pain
Position:
- Pt seated
- Pht facing pt, look for NZ, EF & pain; hold 5sec
wrist MCP collateral ligaments stress tests
Findings:
Gr I sprain: Strong normal EF & pain
Gr II sprain: Solid Firm EF but much further into range & P
Gr III sprain: Sluggish or NO EF with more or less pain
Position:
- Pt seated
- Pht facing pt, look for NZ, EF & pain; hold 5sec
finger DIP and PIP collateral ligament stress tests
Findings:
Gr I sprain: Strong normal EF & pain
Gr II sprain: Solid Firm EF but much further into range & P
Gr III sprain: Sluggish or NO EF with more or less pain
Position:
- Pt seated
- Pht facing pt, look for NZ, EF & pain; hold 5sec
wrist - finkelstein test
wrist - TFCC supination lift test
wrist - TFCC ulnar impaction test
wrist - TFCC load test
F/A - Phalen test
wrist flexion for 60s (+ for CTS)
F/A - Durkan’s median nerve test
- direct compression at CT, hold pressure 30 s, most sensitive test
- for CTS
F/A tinel’s sign
- tapping at a certain point to see if S&S are reproduced
F/A - pronator teres syndrome test
F/A compression tests for PTS
F/A pinch grip test for AINs
F/A froment’s sign for CUTS
F/A - pressure provocation test for CUTS
F/A - elbow flexion test for CUTS
F/A - Froment’s sign for GUTS
F/A - provocative tests for RATS
F/A - Allen’s test for GUTS
- test for vascular flow
1) pt makes fist (both hands)
2) compress artery
3) pt opens fingers
4) see if blood returns at = rate
GH joint ROM/OP - Apley scratch test
GH joint ROM/OP - HBB test
GH joint: antero-superior HBB with ER
GH joint: apprehension test
GH joint: relocation test
* to be done with apprehension test!!
GH joint - sulcus sign test
GH joint - posterior apprehension test
GH joint - compression rotation test
Better diagnostic utility when using specific combination of 3 tests:
1) By selecting 2 highly sensitive tests (true positive)
- Compression rotation test
- O’Brien test
2) And 1 highly specific test (true negative)
- Biceps load II
User can be fairly confident in both ruling out & in SLAP lesions
GH joint - O’Brien’s test
Better diagnostic utility when using specific combination of 3 tests:
1) By selecting 2 highly sensitive tests (true positive)
- Compression rotation test
- O’Brien test
2) And 1 highly specific test (true negative)
- Biceps load II
User can be fairly confident in both ruling out & in SLAP lesions
GH joint - biceps load 2 test
Better diagnostic utility when using specific combination of 3 tests:
1) By selecting 2 highly sensitive tests (true positive)
- Compression rotation test
- O’Brien test
2) And 1 highly specific test (true negative)
- Biceps load II
User can be fairly confident in both ruling out & in SLAP lesions
GH joint - Hawkin’s-Kennedy test
Both Hawkins-Kennedy & Neer tests would be minimally helpful for both ruling in & out subacromial impingement
The presence of a painful arc during elevation may additionally be helpful in identifying impingement
Impingement would not identify which structure is at fault would only identify which movt/mechanism is at fault
GH joint - Neer’s impingement test
Both Hawkins-Kennedy & Neer tests would be minimally helpful for both ruling in & out subacromial impingement
The presence of a painful arc during elevation may additionally be helpful in identifying impingement
Impingement would not identify which structure is at fault would only identify which movt/mechanism is at fault
GH joint - posterior impingement test
Both Hawkins-Kennedy & Neer tests would be minimally helpful for both ruling in & out subacromial impingement
The presence of a painful arc during elevation may additionally be helpful in identifying impingement
Impingement would not identify which structure is at fault would only identify which movt/mechanism is at fault
GH joint - full can test
Remember:
Special tests done
- To isolate the involved structure
- Help to confirm the diagnosis
- But the result of a single test is usually not enough
GH joint - empty can test
Remember:
Special tests done
- To isolate the involved structure
- Help to confirm the diagnosis
- But the result of a single test is usually not enough
GH joint - drop arm test
Remember:
Special tests done
- To isolate the involved structure
- Help to confirm the diagnosis
- But the result of a single test is usually not enough
GH joint - external rotation lag sign (ERLS)
Remember:
Special tests done
- To isolate the involved structure
- Help to confirm the diagnosis
- But the result of a single test is usually not enough
GH joint - internal rotation lag sign
Remember:
Special tests done
- To isolate the involved structure
- Help to confirm the diagnosis
- But the result of a single test is usually not enough
GH sup lig stress test
Pt supine
Pht
Medial hand: Stabilizes scapula superiorly by applying a gentle pressure on the coracoid process
Lateral hand: Grasps proximal humerus
GH mid lig stress test
Pt supine
Pht
Medial hand: Stabilizes scapula superiorly by applying a gentle pressure on the coracoid process
Lateral hand: Grasps proximal humerus
GH inf lig stress test (ant segment)
Pt supine
Pht
Medial hand: Stabilizes scapula superiorly by applying a gentle pressure on the coracoid process
Lateral hand: Grasps proximal humerus
GH inf lig stress test (post segment)
Posterior GH ligaments stress tests
stability test trapezoid ligament
stability test conoid ligament
AC joint special tests
SC joint syability test (compression test)
SC joint syability test (anterior stability)
ST joint - 4-point palpation
Dynamic Scapula Test (abd elevation test)
To assess when Pt’s symptoms are produced in abduction & Scapula dysfunction is present
Pht corrects scapula position
- Stand behind your pt on the side of the shoulder being assessed
- Place one hand anteriorly over the acromion (your arm is between the pt’s arm and their body)
- The other hand is on the scapula posteriorly
- Correct the observed dysfunction (Eg: if the pt’s scapula is not upwardly rotating, create the upward rotation of the scapula with your hands)
- Ask pt to repeat GH abduction as you correct the scapula position & guide the scapula through abduction
*Be aware not to block GH ROM as you are doing the correction q (+)ve test: Improve ROM or reduced pain
Dynamic Scapula Test (ER scapula stability test)
Scapula stability test (Kibler’s lateral slide - lateral scapula slide test)
GH joint - speeds test
PT puts arm at 90 deg flex, full sup (ER) and full elbow ext. manual resistance applied down. + if pain in bicipital tendon/groove. means SLAP or bicipital tendonitis.
