Orthopedic Tests
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| Elbow ROM | Flextion 140-150, Extension 0-10, Valgus 1-15, Pronation 85-90, Supination 85-90
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| Gunstock elbow | Deformity of elbow, resulting from condylar fracture at elbow (forearm deviates toward midline when extended)
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| Carrying angle | aka cubitus valgus (the expected carrying angle in adults is between 0-15deg)
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| Busal sac | fluid filling from trauma or secondarily from RA or gout
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| Cozen's test | Resisted, seated
-resist wrist extension +pain=lateral epicondylitis (attachment of ext.carpi radialis brevis, ext. digitorum, ext. digiti minimi, ext. carpi ulnaris)
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| Mill's test | passive, seated
-pronate and flex the wrist fully and extend the elbow
+pain=lateral epicondylitis (stretches muscle attachment and stress on radial nerve)
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| Golfer's elbow test (reverse Cozen's test) | resisted, seated
-resist wrist flexion
+pain=medial epicondylitis (attachment of flexor carpi radialis/ulnaris)
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| Reverse Mill's test | passive, seated
-extend the wrist
+pain=medial epicondylitis (stretches muscle atttachment and stresses median nerve)
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| Ligament instability (Medial collateral Ligament test aka valgus/abduction stress test) | passive, seated
-abduct forearm
+pain=MCL instability/injury
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| Ligament instability (Lateral collateral ligament test aka varus/adduction stress test | passive, seated
-adduct forearm
+pain=LCL instability/injury
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| Cubital tunnel syndrome | ulnar nerve compression of elbow(numbness/tingling of ring/little finger)
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| Tinel's sign | passive, seated
-tap ulnar nerve between olecranon process and medial epicondyle +parathesia=ulnar nerve impingement
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| Elbow flexion test | active, seated
-flex the elbow
+parathesia=ulnar nerve impingement
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| Radial head/neck fracture | fall on outstretched hand, immediate pain
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| Wrist ROM | Extension=70-90, Flexion=80-90, Abduction=15, Adduction=30-45
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| Radicular pain (nerve entrapment) | Cubital tunnel syndrome, Ulnar tunnel syndrome (Guyon's canal), Carpal tunnel syndrome, Anterior interosseous nerve syndrome
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| Anterior interosseous nerve syndrome | -pain in proximal forearm and weakness of FPL and FDP to the index finger (entrap by the pronator teres muscle)
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| Pinch grip test | active, seated
-pinch tips of index and thumb +pulps of index and thumb touch=injury to anterior interosseous nerve, median nerve
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| Ulnar Tunnel Syndrome | Clawing of he ring finger and hypothenar wasting.
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| Carpal tunnel syndrome | median nerve compression at wrist (repetitive use) F>M
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| Tinel's sign | passive, seated
-tap palmar surface of wrist +tingling at 1,2,3, lateral half of 4th fingers)=CTS
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| Phalen's test | active seated -flex the wrists and place them together for 60secs (median n compressed by flex. ret) +tingling in the hand (1-4 fingers =CTS, anterior dislocation of lunate,arthritic changes, inflammation of flex. retinaculum, tenosynovitis of FD tendons)
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| Reverse Phalen's test | active seated
-extend wrists and place palms together (inc. pressure of carpal tunnel)
+tingling in the hand (1-4 fingers =CTS, anterior dislocation of lunate,arthritic changes, inflammation of flexor retinaculum, tenosynovitis of FD tendons)
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| Pinch test | active seated
-pinch piece of paper w/ thumb, index, and niddle fingers and try to pull it away
+numbness/cramping of 1-4 fingers/palm in 1 min,
+inability to pinch paper=refer for MRI elctromyography
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| Electromyograpy | Diagnose dz that damage muscle tissue, nerves or nm junctions (ie. disc herniation, ALS, myasthenia gravis)
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| Nerve conduction test | Detect and evaluate damage to PNS to help diagnose nerve d/o (ie CTS, Guillain Barre Syndrome)
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| Finkelstein's test | active/passive, seated
-bring the thumb in palm, make fist, then ulnar deviate +pain=tenosynovitis of abductor pollicis longus and extensor pollicis brevis tendons (de Quervain's dz)
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| Ganglion cyst | Encapsulated fluid-filled mass, (joint capsule, tendon sheath), painless
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| Scaphoid fracture | fall onto outstretched hand, high rate of non-union, snuff box tenderness
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| Distal radius fracture | common, osteoporotic fracture (DEXA scans esp postmenopausal women)
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| Colle's fracture | complete transverse fracture w/in distal 2cm radius -distal fragment is displaced dorsally
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| Scapholunate ligament injury | fall on outstretched hand “wrist sprain”, pain medial to snuffbox, diagnosed w/ supinated x-ray
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