12: MSK Tests

Question 1

Which test/maneuver?

Aids in evaluating hip or sacroiliac disease (pain in buttocks, groin, or hip)

Answer 1

Patrick’s Maneuver (FABER or Figure-4 Test)

Question 2

Which test/maneuver?

Flexion, abduction, and external rotation of the leg/hip.

Answer 2

Patrick’s Maneuver (FABER or Figure-4 Test)

Question 3

Which test/maneuver?

Tests for malingering (made up pain)

Answer 3

Waddell Signs

Question 4

Which test/maneuver?

• Apply pressure in the mid-gluteal region.
• A positive sign could indicate potential sciatica or a herniated disc.

Answer 4

Sciatic Notch Test

Question 5

Which test/maneuver?

• Used to assess nerve root pain (radicular pain).
• The examiner turns the patient’s head to the affected side while extending and applying downward pressure to the top of the patient’s head.
• Positive test causes pain to radiate into the upper extremity.

Answer 5

Spurling Test

Question 6

Which test/maneuver?

• Adduct the patient’s arm across the chest.
• Positive test indicates AC joint inflammation or arthritis.

Answer 6

Crossover Test

Question 7

Which test/maneuver?

• Ask the patient to touch the opposite scapula from below and again from over the shoulder (above).
• Difficulty suggests a rotator cuff disorder or adhesive capulitis.

Answer 7

Apley Scratch Test

Question 8

Which test/maneuver?

• Press on the scapula to prevent scapular motion with one hand.
• Raise the patient’s arm with the other.
• Pain indicates inflammation or rotator cuff tear.

Answer 8

Neer’s Impingement Sign

Question 9

Which test/maneuver?

• Flex the patient’s shoulder and elbow to 90 degrees with the palm facing down.
• Then with one hand on the forearm and one on the arm, rotate the arm internally.
• Pain indicates inflammation or rotator cuff tear.

Answer 9

Hawkin’s Impingement Sign

Question 10

Which test/maneuver?

This compresses the tuberosity of the humerus against the acromion.

Answer 10

Neer’s Impingement Sign

Question 11

Which test/maneuver?

This compresses the greater tuberosity against the coracoacromial ligament.

Answer 11

Hawkin’s Impingement Sign

Question 12

Which test/maneuver?

This tests supraspinatus strength.

Answer 12

Empty Can Test

Question 13

Which test/maneuver?

This tests infraspinatus strength.

Answer 13

Patient places arms at the side and flexes elbows to 90 degrees with thumbs turned up. Provide resistance as the patient presses the forearms outward.

Question 14

Which test/maneuver?

• Flex the patient’s forearm to 90 degrees at the elbow and pronate the patient’s wrist.
• Provide resistance as the patient turns arms upward.
• Pain indicates inflammation of the long head of the biceps tendon or rotator cuff tear.

Answer 14

Forearm Supination

Question 15

Which test/maneuver?

• Elevate arms to 90 degrees and internally rotate the arms with the thumbs pointing down.
• Ask the patient to resist you as you place downward pressure on the arms.
• Weakness indicates rotator cuff tear.

Answer 15

Empty Can Test

Question 16

Which test/maneuver?

• Ask the patient to grasp the thumb against the palm and then move the wrist toward the midline in ulnar deviation.
• Pain indicates deQuervain’s tenosynovitis.

Answer 16

Finkelstein’s Test

Question 17

Which test/maneuver?

• Ask the patient to raise the thumb straight up as you apply downward resistance.
• Weakness is a sign of carpal tunnel.

Answer 17

Thumb Abduction

Question 18

Which test/maneuver?

• Tap lightly over the median nerve.
• Aching and numbness in the first 3 fingers indicates carpal tunnel.

Answer 18

Tinel’s Sign

Question 19

Which test/maneuver?

• Hold the wrists in flexion for 60 seconds.
• Alternatively, ask patient to press the backs of both hands together to form right angles for 60 seconds.
• Numbness and tingling in the first 3 fingers is positive.

Answer 19

Phalen’s Sign

Question 20

Which test/maneuver?

• Suprapatellar compression ejects fluid into the spaces adjacent to the patella.
• Causes a palpable fluid wave.

Answer 20

Balloon Sign

Question 21

Which test/maneuver?

• With the patient supine, grasp the heel and flex the knee.
• Cup your other hand over the knee joint with fingers and thumb along the medial joint line.
• From the heel, externally rotate the lower, then push on the lateral side to apply valgus stress on the medial side of the joint.
• At the same time, slowly extend the lower leg in external rotation.
• Repeat maneuver with internal rotation and fingers over lateral joint line.
• Positive sign is a click (felt/heard), tenderness along joint line.

Answer 21

McMurray Test

Question 22

Which test/maneuver?

• Patient supine, knee slightly flexed, move the thigh about 30 degrees laterally.
• Place one hand against the lateral knee to stabilize the femur and the other hand around the medial ankle.
• Push medially against the knee and pull laterally at the ankle to open the knee joint on the medial side.
• Pain or a gap in the medial joint line is positive.

Answer 22

Valgus Stress Test (Abduction)

Question 23

Which test/maneuver?

This tests the MCL.

Answer 23

Valgus stress Test (Abduction)

Question 24

Which test/maneuver?

This tests the LCL.

Answer 24

Varus Stress Test (Adduction)

Question 25

*Which test/maneuver?* * Patient supine, knee slightly flexed, move the thigh about 30 degrees laterally. * Place one hand against the medial knee to stabilize the femur and the other hand around the lateral ankle. * Push laterally against the knee and pull medially at the ankle to open the knee joint on the medial side. * Pain or a gap in the lateral joint line is positive.

Answer 25

Varus Stress Test (Adduction)

Question 26

*Which test/maneuver?* * Have the patient lie supine with legs extended. * Squeeze the calf. * Positive sign has no plantar flection.

Answer 26

Thompson Squeeze Test

Question 27

*Which test/maneuver?* * Patient lies on stomach and bends knees up. * Presss down on the heel. * Positive sign is pain.

Answer 27

Apley's Grind Test

Question 28

*Which test/maneuver?* * Patella bounces up and down when you touch it. * Effusion or pocket of fluid under the patella.

Answer 28

Patellar Ballottement

Question 29

*Which test/maneuver?* * Arm at 90 degrees. * Anterior pressure and external rotation. * Pain or fear of the feeling of subluxation. * Positive test indicates glenohumeral instability.

Answer 29

Apprehension Test