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Orthopedic Tests

Tests with positive findings

Test NameDescription
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
Created by: soccerdocpj on 2004-06-24



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