Duke PA Ortho special tests/signs
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| Apply inferior traction with arm at side. Positive for AC joint instability if there is a gap between humeral head and acromion | Sulcus sign
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| Arm at 90 deg forward flexion, passive IR Pain is positive for impingment/RC tendonitis | Hawkins
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| start with arm at 90 deg forward flex and pronation, hold scap and passively forward flex to overhead. Pain is pos. for supraspinatus impingment. | Neer's
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| Have patient horizontally ADD arm. Pain is positive for AC injury | Cross over test
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| IR with hand on back. If pt cannot lift hand off back pos for weakness/tear of subscapularis | lift-off test
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| With pt supine and arm at side with elbow flexed to 90, place your finger on biceps tendon. Externally Rotate. Pos for biceps tendonitis if pain or feel tendon slip out of groove | Yergason's test
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| Pt arm starts in forward flexion and supination, resist this motion, pain is pos for biceps tendonitis | Speed's
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| Shoulder AB to 90, elbow flexed to 90. Apply pressure behind humeral head and ER shouder. Pos for anterior instability if pain. | Apprehension test
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| Tapping on volar aspect of wrist over carpal tunnel will reproduce pain/parethesias in median nerve distribution. Pos for carpal tunnel syndrome. | Tinnel's
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| Place dorsum of hands together for 1 min. Pos for carpal tunnel syndrome if pain/paresthesias in median nerve distribution. | Phalen's
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| radial head fx in adults, supracondylar fx in kids | Posterior fat pad sign
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| usually normal, sail sign | Anterior fat pad sign
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| Test for disc herniation. Pt lies supine and leg is elevated. Pos is radicular pain below the knee. | Straight leg raise test
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| Essentially place foot of affected leg on pt's unaffected knee (Flexion, Abduction, ext. rotation). Hold opposite ASIS and apply downward pressure to affected knee. Pain is pos for problem with SI joint. | FABER test
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| Test for lumbar nerve root irritation. Pt sitting, passively extend affected leg. Pain is pos test (patient will put hands on table and arch backward) | Flip test
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| Gold standard for ACL tear. Knee flexed 15 deg. stabilize femur with one hand and tibia with other. Move tibia forward. Pos for ACL tear if movement and soft end point | Lachman
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| Knee flexed 90 deg. stabilize foot on table, pull tibia forward. Laxity can indicate ACL injury | Anterior drawer
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| Test for ACL dysfunction-Apply valgus stress,IR force and extend the knee. Maintain valgus stress and IR, and flex knee to 30 deg. ACL deficient knee will anterolaterally sublux on distal femur. | Pivot shift
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| For chronic PCL tear. Flex knee to 90 deg, stabilize heel on table. Tibia will droop at knee joint. | Sag sign
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| Knee flexed to 90 deg, stabilize foot on table. Move tibia posterior. Laxity can indicate PCL injury | Posterior drawer
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| Test for LCL injury, apply stress to medial knee while stabilizing lower leg. | Varus stress
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| Test for MCL injury, apply stress to lateral knee while stabilizing lower leg | Valgus stress
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| Test for miniscus injury. One hand on joint line and the other on the sole of the foot. Flex knee to 90 deg. IR/ER and extend the knee. Palpable or audible click | McMurray
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| Test for meniscal tears. Pt in prone position, flex knee to 90 deg, apply load through foot and IR/ER rotate. Pain is pos test. | Apley grind test
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| Cup hand around superior patella. Have pt contract quads while applying pressure. Pain is pos sign for patellar injury. | Patella grind
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| Draw line from ASIS to tibial tubercle. Draw straight line from tibial tubercle up. Measure angle. Females less than 17, males less than 14 is normal. | Q angle
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| Pt lying on side. Hold hips in neutral and cradle affected leg. Bring pt into hip flexion then adduction and extension. Let leg drop, if leg stays elevated positive for IT band tightness. | Ober test
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| put foot into 10 deg plantar flexion, stabilized tibia, other hand on heel and move ankle mortis forward on tibia. Pain and laxity pos for lateral ankle sprain. Tests ATF. | Anterior drawer (ankle)
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| Dorsiflex foot to 10 deg. Hold heel and invert talus/calcaneous on tibia while supporting tibia with other hand. Pain and laxity pos for lateral ankle sprain (CF). | Talar tilt
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| evert talus/calcaneous on tibia while supporting tibia with other hand. Pain and laxity pos for medial ankle sprain (deltoid lig.) | Valgus stress (ankle)
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| With both hands press tibia and fibula together. Pain indicates injury to syndesmosis. | Squeeze test
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| Pt in prone position, squeeze calf. Lack of plantar flexion indicitive of achilles tendon rupture. | Thompson's test
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| Fusiform swelling of fingers, significant tenderness along the course of the tendon, marked pain on passive extension, flexed finger at rest. Positive for septic tenosynovitis. | Kanavel sign
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