Term
Modified Lachman's Test
*grades of instability? |
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Definition
(regular lachmans is the same as ant drawer)
Pt supine. Flex knee 20-30 degrees, stick own knee underneath to use as bolster. Stabilize femur segment w/ one hand, perform ant drawer w/ other hand (lumbrical grip).
Assess for degree of ant glide.
May be graded 1-4 for (3-6, 6-9, 10-16, >16) |
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Term
Valgus/Varus Tests
*grading instability? |
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Definition
| Valgus - Pt supine, hold the leg btwn arm and side (secure foot position if able, to keep from ER/IR the hip). W/ in side arm, palpate MCL/joint line with fingertips W/ outside arm, use hand to block femur just prox to knee. Rotate body to apply valgus stress. Varus - same concept but sitting on table btwn pt's legs, palpating LCL w/ fingertips Do at 20-30 deg, and also at 0 deg if time (detects "major instability") Gapping is + test for ligamentous pathology. Can be graded 1-3 (for gapping of 5,10,>10 and 5,8,>8 respectively) |
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Term
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Definition
| Pt supine, knee flexed 20-30, sit on pt foot and use both hands to apply ant glide. |
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Term
Post drawer
*which 2 tests to check first? |
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Definition
*Post sag sign
*Godfrey test
Pt supine, knee flexed 20-30, sit on pt foot and use both hands to apply ant glide. |
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Term
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Definition
Pt supine w/ knees flexed 20-30 and feet flat – see if tibia drops back due to gravity
Same as godfrey test but w/ feet flat on table. Look at both legs at same time to compare. |
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Term
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Definition
| Pt supine w/ knee/hip at 90/90, support weight of pt legs and see if tibia segment drops back due to gravity. Look at both legs at same time. |
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Term
| Slocum Test (2nd part of test = "Lemaire's") |
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Definition
| Perform ant drawer with foot in IR 30 and ER 15. Excessive ant glide (base on other leg) indicates + test for anterolat (IR- part 1) or anteromed (ER - part 2) instability |
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Term
Houghston's Test
(knee ligamentous) |
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Definition
| Post drawer w/ slight IR. Excessive sag (compared to other leg) indicates + for posteromed instability. |
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Term
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Definition
| Pt supine, legs straight; Lift legs up by grasping medial foot near big toe, watch for lag (sag) at posterolat corner. Excessive sag (compared to other leg) indicates + for posterolateral instability. |
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Term
| Apley's Test (knee meniscus) |
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Definition
Phase 1 - Pt prone, knees bent 90 deg. Apply axial compression through foot, stabilizing femur w/ other hand.
ER/IR the foot.
(Same as elbow grind test for UE. but load and rotate.)
No pain indicates - test. Proceed if pain response.
Phase 2 – Same handling, but DISTRACT by pulling up on the ankle.
If is still painful, + test for ligamentous pathology.
If not painful, + test for meniscus tear. |
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Term
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Definition
Pt supine, knee bent 90 deg. Apply axial compression through foot and palpate joint line w/ same hand, with other hand rotate foot first medially, taking through knee flex/ext and valgus/varus, then change grip and ER, do the same sequence.
Snapping, clicking and usually pain indicate + test for meniscus tear (post-lateral meniscus if pain w/ IR, post-medial meniscus if pain w/ ER; valgus/varus picks up on anterior portions) |
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Term
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Definition
| Pt supine; hip flexed at 90, IR the foot and hold against side/under arm, Hold at 30 degrees of knee flexion--> use heel of hand to push patella medially --> take in to passive flex/ext. pain is + test for plica involvement. |
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Term
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Definition
Knee flex 30 degrees, slide own knee underneath, and glide patella medially,
Pain indicates + test for plica involvement. |
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Term
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Definition
| Pt seated. Slowly extends knee; + for plica involvement if patella jumps/stutters between 60 - 45 degrees. PT just palpates the patella during the motion. (no stabilization for this one) |
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Term
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Definition
| PT to rest hand on pt's knee and monitor patella as patient squats; + for patellofemoral problem if pain and crepitus |
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Term
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Definition
Pt stands next to 6-in step, steps up sideways onto it. Knee pain, or inability to do it indicates + test for patellofemoral problem or weak quad
Test good leg first. |
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Term
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Definition
| Pt supine or long-sitting. PT moves patella as far lateral as possible, feels underside for "shelf". Indicates + test for patellofemoral involvement. |
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Term
Q-angle Test
*normal?
*what is indicated by too large or small angle? |
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Definition
Pt supine, foot in neutral. Drop tape from ASIS (can have pt hold in place) to midpoint of patella. Measure btwn this line and imaginary line connecting tibial tuberosity to midpoint of patella.
*Normal: 13 deg for males, 18 deg for females
Abnormally small angle = chondromalacia or patella alta
Abnormally large angle = chondromalacia, sublux patella, or Fem Anteversion |
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Term
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Definition
| Pt supine, knee/hip in 90/90. thumb applies pressure just prox to lat fem condyle & passively extends pt leg. Pain matching symptoms at 30 deg indicates + test for ITB Friction Syndrome. |
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Term
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Definition
Same as Noble Compression Test but pt standing, performs a deep squat. Apply pressure w/ thumbs just prox to lat fem condyle only on the way up from squat.
(Noble compression test: knee/hip in 90/90. thumb applies pressure just prox to lat fem condyle & passively extends pt leg.)
Pain matching symptoms at 30 deg indicates + test for ITB Friction Syndrome. |
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Term
| Fairbanks Apprehension Test |
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Definition
Pt supine, use own leg as bolster to keep 30 degree bend in knee.
Shift patella laterally & have pt contract the quad.
+ test if apprehension and/or quad contraction, indicates displaced patella |
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Term
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Definition
10 second isometric contractions at various angles: 0,30,60,90,120
i. If pain at 60 degrees, impose medial patellar glide, have them repeat 60 degree test
ii. + sign is pain goes away – can tape medial to counter the lateral pull that is most common (“mcconnell taping”)
iii. Also, can use this test to tailor the HEP, keep them out of that painful range |
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Term
| Patellar Tap/Ballotable Patella Test |
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Definition
| tap patella w/ thumbs of both hands and feel for accumulation “float’ or place finger and thumb on sides and milk to see if fingers separate; Detects large amounts of swelling |
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Term
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Definition
| PT places palm of one hand over the suprapatellar pouch and the other anterior to the joint with thumb and index finger just beyond the margins of the patella, presses down with one hand and then the other (milk up then down) |
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Term
| Peripatellar swelling test |
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Definition
| – pt. supine with knee extended, PT milks fluid from the suprapatellar pouch distally and monitors medial side of patella. |
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