Mulder’s Click
A key diagnostic sign for Morton’s neuroma, a painful nerve condition in the foot, identified during the Metatarsal Squeeze Test; it’s a painful clicking or popping sensation felt when a doctor squeezes the forefoot, forcing the inflamed nerve (neuroma) between the metatarsal bones, often between the 3rd and 4th toes. It signifies nerve compression, often causing burning pain, numbness, or a feeling like standing on a pebble.
Thompson Test
The Thompson test, also known as the calf squeeze test, is a quick clinical exam to check for a complete rupture of the Achilles tendon; the patient lies face down with feet off the bed, and if the examiner squeezes the calf muscle and the foot doesn’t point down (plantar flex), it indicates a positive result, suggesting the tendon is torn because the muscle isn’t connected to the heel bone.
Allis Test
The Allis test (or Galeazzi test) is an orthopedic screening for leg length inequality and hip problems, especially developmental hip dysplasia (DDH) in children, performed by flexing a patient’s hips (45°) and knees (90°) in a supine position; if one knee sits lower, it suggests a potential femoral shortening or hip dislocation, while a higher, more forward knee might indicate a tibial issue. It helps differentiate bone shortening (femur/tibia) from functional issues, though its use in adults is debated.
Heel Squeeze Test
The heel squeeze test (or calcaneal squeeze test) is a physical exam to diagnose heel pain, especially in children, by compressing the sides of the heel bone (calcaneus); pain during the squeeze suggests conditions like Sever’s disease (calcaneal apophysitis) or a stress fracture, as it specifically targets bony issues rather than soft tissues like the plantar fascia.
Foot Posture Index -6
A widely used clinical tool for quickly assessing static foot posture (pronation vs. supination) in standing by evaluating six specific criteria, scoring each from -2 (supinated) to +2 (pronated), leading to a total score from -12 to +12 to classify the foot as neutral, slightly pronated/supinated, or severely so, helping identify biomechanical risk factors for injury.
Thomas Test
The Thomas Test is a physical exam used by healthcare providers to check for tightness in the hip flexors (iliopsoas, rectus femoris) and related muscles.
Galliazzi
The Galliazzi test (or Allis test) is an orthopedic screening for leg length inequality and hip problems, especially developmental hip dysplasia (DDH) in children, performed by flexing a patient’s hips (45°) and knees (90°) in a supine position; if one knee sits lower, it suggests a potential femoral shortening or hip dislocation, while a higher, more forward knee might indicate a tibial issue. It helps differentiate bone shortening (femur/tibia) from functional issues, though its use in adults is debated.
What is the Modified Ashworth Scale?
The Modified Ashworth Scale (MAS) is a clinical tool used to assess muscle spasticity, providing a standardized method for evaluating resistance during passive movement.
The MAS employs a six-point ordinal scale to quantify resistance to passive movement, with scores ranging from 0 to 4, plus an additional score of 1+ for slight increases in muscle tone. Here’s a breakdown of the scoring:
0: No increase in muscle tone (normal movement).
1: Slight increase in muscle tone, manifested by a catch and release or minimal resistance at the end of the range of motion.
1+: Slight increase in muscle tone, with a catch followed by minimal resistance throughout less than half of the range of motion.
2: More significant increase in muscle tone through most of the range of motion, but the affected part is still easily moved.
3: Considerable increase in muscle tone, making passive movement difficult.
4: Affected part is rigid in flexion or extension, indicating an extreme increase in muscle tone where passive movement is virtually impossible.
What is the Tardieu Scale?
The Tardieu Scale is a clinical tool used to measure muscle spasticity, particularly in neurological conditions like stroke or cerebral palsy, by assessing resistance to passive limb movement at different speeds (slow and fast) to distinguish true spasticity from muscle contracture, using angles (R1 and R2) and a quality-of-reaction score (0-5) to quantify the muscle’s “catch” and range of motion. A key aspect is the difference between R2 (full slow range) and R1 (catch point at fast stretch), with a larger difference indicating less spasticity.
How does the Tardieu Scale work?
Measures Velocity-Dependent Resistance: Unlike some scales, it specifically tests how muscle resistance changes with the speed of movement.
R1 (Catch Angle): The angle where the first resistance (catch) is felt during a fast passive stretch.
R2 (Full Range Angle): The maximum angle achieved during a slow, relaxed passive stretch.
Quality Score (0-5): Rates the muscle’s response:
0: No resistance.
1: Slight resistance.
2: Clear catch followed by release.
3: Fatigable clonus (spasm).
4: Unfatigable clonus.
5: Joint immobile.
Calculated Difference (R2-R1): A larger difference indicates less spasticity (more contracture), while a smaller difference suggests more severe spasticity.
Anterior Drawer Test
Clinical test for ACL tear.
Performed with the knee bent at 90 degrees, the examiner pulls the tibia forward; a significant forward shift or soft endpoint indicates a positive (torn) result.
Posterior Drawer Test
Clinical test for PCL tear.
The knee is bent to 90 degrees, and the examiner pushes the tibia backward to check for increased posterior movement compared to the other leg, indicating a tear.
Posterior Sag Sign (Gravity Draw)
Clinical test for PCL injury.
With the hip at 45 degrees and knee at 90 degrees, the tibia sags backward due to gravity if the PCL is torn; extending the knee then brings the tibia forward.
Ryder’s Test
Ryder’s test, commonly known as Craig’s test or the trochanteric prominence angle test, is a clinical examination used to measure femoral anteversion or retroversion (torsion of the thigh bone). It involves palpating the greater trochanter while rotating the hip in a prone position to determine the angle of twist in the femur.
Jack’s Test
The Jack’s test (or Hubscher maneuver) is a clinical, weight-bearing assessment of the foot’s windlass mechanism and arch stability, commonly used to distinguish between flexible and rigid flatfoot (pes planus). It involves passively dorsiflexing the big toe (hallux) while the patient stands; a positive result (normal) shows the arch raising.
Cranial Vault Asymmetry Index
For infants, the Cranial Vault Asymmetry Index (CVAI) is often used to assess flatness, calculated.
It is calculated by dividing the absolute difference between cranial diagonal measurements by the longer diagonal and multiplying by 100. CVAI over 3.5% is generally considered abnormal, indicating a need for potential intervention.
Cranial Index
The cranial (or cephalic) index is calculated by dividing the maximum cranial breadth (width) by the maximum cranial length, then multiplying by 100 to determine head shape classification, often used in anthropology and medicine.
