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Special Tests
Knee Special Tests
Special Test | Method of Test & Indications |
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Valgus Stress | MCL.Push knee medial while stabilizing ankle. Do in extension & 20° flexion. (+ = tibia moves away from femur; indicative of injury to: extension: MCL, POL, Postmed caps, ACL, PCL, Semimemb. flexion: MCL, POL, PCL, postmed capsule. |
Varus Stress | LCL.Push knee lateral while stabilizing ankle. Do in extension & 20° flexion. (+ = tibia moves away from femur; indicative of injury to: extension-LCL,postlat. capsule,biceps fem ten,PCL,ACL,IT band. flexion-LCL,postlat capsule,IT band,biceps fem. ten |
Lachman Test | Put knee between extention & 30° flexion. Stabilize femur w/ outside hand and move tibia forward w/ inside hand. (+ = soft end feel; indicates injury to ACL, POL. |
Anterior Drawer | Start w/ knee flexed to 90° & hip at 45°. Stabilize foot & place hands around tibia & draw forward on femur. (+ = mvmt > 6mm; indicates injury to ACL, postlat caps, postmed caps, MCL, IT band, POL. |
Posterior Drawer | Knee flexed 80-90 degrees and hip flexed 45 degrees. Push tibia back on femur. (+ = posterior sag; indicative of injury to PCL, POL, ACL.) |
Anteromedial | Ant. Drawer w/ ER. (+ = Excessive motion; injury to ACL, Postmedial capsule, MCL) |
Anterolateral | Ant. Drawer w/ IR.(+ = Excessive motion; indicative of injury to LCL, Posterolateral capsule, & ACL) |
Posteromedial | Post. Drawer w/ ER. (+ = Excessive motion; indicative of injury to PCL, MCL, Posteromedial capsule) |
Posterolateral | Post. Drawer w/ IR. (+ = Excessive motion; indicative of injury to PCL, LCL, Posterolateral capsule) |
McMurray's | Supine w/ knee flexed (foot to butt). Medially rotate tibia & flex knee. Repeat w/ laterally rotating tibia. (+ = Snap or click w/ pain; indicative of loose fragment of meniscus. Lateral rotation: medial mensicus. Med rotation: lateral meniscus. |
Apley's Compression/Distraction | Prone w/ knee flexed to 90°. Medially & laterally rotate tibia w/ distraction. Note restriction, exces. mvmt, pain. Repeat w/ compression. (Rotation+distraction is worse: ligamentous injury. Rotation+compression is worse: meniscus injury.) |
Q-angle | Angle between quads and the patellar tendon. Draw a line from ASIS to the midpoint of the patella & then another from tibial tubercle to midpoint of patella. This is Q angle. Incr. Q-angle causes lat. tracking, while decr. Q-angle centralizes tracking |
Patellar Mobility | Ability to move patella superior-inferior, and medial-lateral. |
Hughston Plica Test | Lies supine. Flex knee & medially rotate tibia w/ 1 hand & press patella medial (heel) & palpate femoral condyle w/ other hand.Flex & extend knee and feel for "popping." Popping indicates a positive test for a plica. |
Sweep Test | Tests for edema. Compress above knee and milk downward toward knee. Then compress below knee and milk upward toward knee. Look for a bubble of fluid going from one side to the other. |
IT Band Tightness | (blank) |