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Orthopedic Tests
Tests with positive findings
| Test Name | Description |
|---|---|
| Adam's test | + Rib hump indicating structural scoliosis |
| Adson's | + decrease/ loss in pulse which indicates neurovascular compression (TOS, cervical rib, Ant. scalene Syndrome) |
| Allen's | + >15 seconds indicates distal artery disease (scleroderma, thrombangitis obliterams, Raynaud's, vasospastic conditions) |
| Allis' | + one knee higher that other indicates possible leg length inequality |
| Ankle Clonus | + Multiple beat clonus strongly suggests UMN lesion of SC or brain |
| Anvil Test | + hip pain indicates hip pathology such as DJD, arthritis, Fx or others |
| Bakody Sign | + raised arm above head reduces pain and relieves tension on the NRs, SNs, and brachial plexus indicating a cervical radiculopathy |
| Bechterew's | + leg pain that electrical or shooting indicating radiculopathy |
| Beevor's | + umbilical deviation as a result of muscle weakness or paralysis indicating lower thoracic nerve root compression or neurological demyelination |
| Belt Test | + pain w/ and w/o stabilization indicates pain is lumbar in origin; + pain w/o stabilization, but no pain w/ stablization indicates pain is of pelvic/SI origin |
| Bonnet's Test | + pain upon stretching the piriformis indicates sciatica or local piriformis damage |
| Bowstring Test | + electrical/shooting leg pain indicating radiculopathy |
| Bracelet Test | + pain upon pressure indicates wrist pathology (RA, fracture, sprain) |
| Brachial Stretch Test | + symptom reproduction indicates tension problem with the brachial plexus |
| Braggard's Test | + electrical/shooting leg pain indicating nerve root tension or compressive radiculopathy |
| Brudzinski's | + knee flexion indicates meningeal irritation or inflammation such as meningitis, arahnoiditis, subarchnoid fibrosis, sciatic radiculopathy) |
| Bunnel-Littler Test | + lack of joint movement indicates an inflammatory process in the fingers (OA, RA) |
| Cervical Compression | + arm pain indicates nerve root compression or pain referral; + neck pain indciates joint and ligament strain |
| Cervical Distraction | + decrease in peripheral pain as a result of decrease pressure on NRs indicates IVF encroachment and/or radiculopathy; + increase in pain indicates joint capsule sprain |
| Codman's Arm Drop | + pain indicates rotator cuff tear |
| Dejeurine's Triad | + leg pain indicates nerve root lesion; + local pain indicates sprain/strain |
| DeKleyn's | + vertigo, blurred vision, nausea, snycope, nystagmus indicates Vert. A. ischemia on ipsi side of lesion |
| Doorbell Sign | + Arm pain indicates nerve root tesion/radiculopathy; + local pain indicates cervical sprain/strain |
| Eden's | + diminished pulse indicates costoclavicular TOS; + arm pain, numbness, tingling indicates TOS of neurological nature |
| Ely's | + decreased motion indicates rectus femoris or hip flexion contracture |
| Fabere's Test | + hip pain indicates a hip pathology |
| Femoral Nerve Stretch Test | + pain/neuro Sxs to ant thigh indicates femoral nerve tension; + SI pain indicates SI sprain/strain (see Yeoman's) |
| Gaenslen's | + SI pain or pain down the extended thigh indicates SI lesion such as Ant SI ligament sprain or SI inflammation |
| Goldthwaite's Test | + pain before lumbar motion indicates SI lesion; + pain after lumbar motion indicates lumbar lesion |
| Halstead Maneuver | + reproduction of S/Sxs such as paresthesias indicate neurovascular compression (TOS, cervical rib, Anterior Scalene Syndrome) |
| Heel to Shin Test | + failure to perform or abnormal moverments indicates cerebellar dysfunction |
| Heel Walk | + loss of dorsiflexion indicates LMN lesion of L4 or L5 NRs; if isolated great toe extention is weak consider L5 level |
| Hibb's Test | + SI pain indicates SI lesion; + Hip pain indicates hip lesion/sprain; + radiating pain down the back of the leg indicates piriformis entrapment of sciatic nerve |
| Hip Circumduction | + hip pain indicated hip lesion such as arthritis, inflammation or sprain |
| Hoffman's | + clawing or gripping of thumb and fingers indicates UMN lesion (cervical spondylosis, MS, SC compression) |
| Kemp's | + LBP with leg pain indicates radiculopathy; + local back pain indicates a local lesion which could possbily be a sp/st, facet syndrome, or meniscoid entrapment |
| Kernig's | + leg pain indicates radiculopathy; + increase resistance indicates tight hamstrings |
| Laguerre's Sign | + SI pain indicates SI pathology; + Hip pain indicates a hip lesion such as arthritis, inflammation, or sprain |
| Lewin Standing Test | + pain w/ knee snapping back into extention indicates hamstring spasm or NR tension **perform after Neri Bowing Sign is seen** |
| Lewin Supine Test | + inability to perform a situp due to local or radiating pain indicates lumbar arthritis, spondylolithesis, sciatica, or possibly disc herniation |
| Lewin-Gaenslen Test | + SI pain indicates SI lesions (sp/st, inflammation) |
| Lhermitte's Sign | + sharp, shooting pain down the spine indicates possible cord tumor, post column disease, meningeal adhesions or MS |
| Lindner's Sign | + pain at the lesion level and radicular symptoms indicates NR compression |
| Milgram's Test | + pain indicates SOL possibly a disc herniation |
| Minor's Sign | + pt using hands to walk up the legs indicates lumbosacral pathology such as SI/lumbar sp/st, Fxs, disc synd, muscular dystrophy, or sciatica |
| Nachlas' Test | + local pain indicates SI/lumbar ligament sprain; + radiating pain indicates femoral nerve pathology |
| Neri Bowing Sign | + knee flexion with trunk flexion indicates NR tension or SI/lumbar sp/st **perform Lewin Standing Test upon seeing Neri Bowing Sign |
| Ober's Test | + hip pain indicates hip pathology; + trocanteric pain indicates trocanteric bursitis |
| Patrick's Test | + hip pain indicates hip pathology |
| Romberg's Test | + swaying/poor balance indicates post column lesion |
| Roo's Test | + inability to maintain, numbness, tingling, or weakness indicates TOS |
| Rust Sign | + pt supporting neck suggests possible upper cervical fx, RA, or severe sp/st. |
| Shoulder Depression Test | + arm pain suggests radiculopathy; + local pain suggests cervical pathology (sp/st) |
| SI compression | + pain suggests sp/st, SI lesion or Fx |
| SI Distraction | + pain indicates SI sp/st or Fx |
| SLR | + radicular pain suggests NR tension; + local pain suggest extradural involvement @ 0-35 degress, disc involvement @ 35-70 degrees, Lumbar jt pain @ 70-90 degrees |
| Soto-Hall Test | + radicular pain indicates NR tension; + local pain indicates cervical sp/st |
| Swivel Chair Test | + Vertigo indicates problem is cervical in origin |
| Tandem Gait | + inability to perform indicates cerebellar lesion or influence of alcohol |
| Thomas Test | + elevation of straight leg indicates hip contracture or iliopsoas tightness |
| Trendelenberg Test | + pelvic lateral tilting indicates weak abductor muscles, esp glut med (conditioning or neurological deficit) |
| Valsalva Maneuver | + Increase in Sxs indicate radicular syndrome (disc bulge or herniation) |
| Wright's Test | + reproduction of Sxs such as numbness, tingleness, or weakness indicates TOS |
| Yeoman's Test | + SI pain indicates SI sp/st; + pain/neurologic Sxs into anterior thigh suggests femoral nerve tension |
| Thumb Abduction Stress Test | + pain over the ulnar collateral ligament of the thumb indicates sprain due to hyperabduction, hyperextension injury; + empty endfeel &/or excessive motion indicates severe sprain joint instability, Stener lesion |
| Thumb Grinding Test | +pain/crepitis indicates trapeziometacarpal arthritis |
| Wrist Drop Test | + inability to hold hand in extended position indicates wrist extensor weakness, paralysis due to radial neuropathy |
| Finkelstein Test | + pain indicates De-Quervain's or Hoffman's dis/tenosynovitis; "Squeaking/crepitis" indicates intersection syndrome (tendonitis ofthe extensor carpi radialis longus and brevis) |
| Froment's Test | + inability to perform indicates paralysis of palmar interossei due to ulnar neuropathy; + weakness may indicate subtle ulnar palsy |
| Opposition Test | + weakness indicates median neuropathy involving opponens pollicis |
| Pinch Test | +inability to maintain/weak pinch grip indicates weakness of flexor pollicis longus (anterior interosseous neuropathy- deep branch of the median nerve) |
| Phalen's Test | + numbness distribution of the median nerve, increased anterior pain and subsequent weakness of thumb opposition indicates carpal tunnel syndrome |
| Prayer Test | + numbness distribution of the median nerve, increased anterior pain and subsequent weakness of thumb opposition indicates carpal tunnel syndrome |
| Cozen's Test | + pain/weakness indicates lateral epicondylitis |
| Mill's Test | + lateal elbow pain during test indicates lateral epicondylitis; + restricted ROM indicates arthritis, capsular adhesions tothe overlying common tendon, or tendon contracture |
| Sulcus Sign | + abnormal prominence of acromion & groove-like depression below acromion indicates inferior instability (or multi-directional instability), glenohumeral dislocation, atrophy of deltoideus |
| Step-off, Step Defect/Deformity | + prominence of distal clavicle in relation to acromion indicates AC separation |
| Scapular Winging | + flaring of scapula/indicates paresis/paralysis of serratus anterior; + subtle posterolateral winging indicates pareiss/paralysis of trapezius due to spinal accessory lesion |
| Shoulder hiking | + elevation of ipsilateral shoulder girdle & lateral flexion of trunk to opposite side to compensate for inadequate GH mobility or weakness indicates frozen shoulder, cuff tears, and advanced osteoarthritis; + subtle hiking could prove to be a muscle imb |
| Sulcus Test | + increased motion indicates dislocation, excessive inferior translation, accentuation of the sulcus sign, inferior or multidirectional instability |
| Dugas Test | + inability to complete test indicates anterior GH dislocation |
| Apley's Superior Scratch Test | + pain indicative of impingement, rotator cuff pathology, AC arthritis, labral pathology, GH arthritis, subacromial bursitis or GH capsular pathology; + inability to complete maneuver indicates capsular contracture &/or internal GH rotator tightness |
| Apley's Inferior Scratch Test | + inability to complete maneuver indicates external GH rotator tightness or pathology, labral pathology, or capsular contracture |
| Codman's Drop Test | + pain/weakness indicates "painful arc syndrome" (bursitis, rotator cuff strain, tendonitis or impingement); + patient unable to maintain 90 degrees abducted position against gravity (less than +3/5 muscle strength) indicates severe injury (grade 3 cuff |
| Anterior Apprehension Test | + excessive anterior translation, dislocation or evidence of patient apprehension indicates anterior instability (inferior glenohumeral ligament laxity) |
| Faegin's Test | + clunk/excessive inferior translation indicates inferior or multidirectional instability |
| Yergason's Test | + pain &/or weakness indicates biceps strain/tendonitis; + snap or pop indicates subluxating biceps (long head) tendon |
| Hawkins-Kennedy Test | + sharp anterolateral pain indicating supraspinatus impingement |
| Impingement Sign | + pain during active flexion indicating shoulder impingement syndrome; + pain in internal rotation indicates supraspinatus impingement; + pain in external rotation indicates biceps long head impingement |
| Hyperextension Test | + pain in shoulder indicates biceps tendinitis |
| Speed's Test | + pain indicates bicipital tendonitis, may produce pain with SLAP lesion |
| Empty Can Test | + pain/weakness indicates injury/lesion of supraspinatus |
| Crank Test | + shoulder pain and crepitus (grinding or popping0 indicating a labral tear |
| Clunk Test | + pain with associated clunk or grinding indicates labral tear, may also produce apprehension if shoulder is unstable |
| O'Brien's Test | + GH pain and crepitus & reduced or eliminated during the 2nd part indicates a labral tear; + Anterior shoulder pain increased with palm up indicates biceps tendonitis |
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soccerdocpj
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