Hoffman Test
a neurological exam checking for an upper motor neuron lesion (UMN) by flicking the middle fingernail;
A positive sign (thumb and index finger flex) suggests UMN dysfunction from conditions like spinal cord compression or multiple sclerosis,
Inverted Supinator Sign Test
a neurological test for an upper motor neuron lesion, especially in the cervical spine (C5-C6)
Tapping the radial styloid normally causes elbow flexion but instead triggers rapid finger flexion (making a fist) and no brachioradialis contraction, indicating spinal cord dysfunction
Positive on a Trepmann Test
Maximizing pressure on the posterior tibial nerve. It involves holding the patient’s ankle in maximum plantarflexion and inversion for 30 seconds. (compression test- not stretch test)
Reproduction of symptoms, including numbness, paresthesia (tingling), or pain in the toes, ball of the foot, or heel
.
This test has a reported sensitivity of 85.9% and a specificity of 100%, making it excellent for confirming tarsal tunnel syndrome
Sweep Test
Purpose: assess for joint effusion- presence of increased intra-articular fluid in the knee area
Performance: Stroke upward medial joint line and then stroke downward lateral joint line
Result: bulge reappears medially near patella
0 - no fluid-wave while performing a downward stroke.
Trace - a small bulge on the medial aspect of the knee
1+ - a larger bulge
2+ - medial fluid returns to its position without performing a downward sweep
3+ - excess of fluid that makes it impossible to stroke the medial fluid away`
Trepman Test - Triple Compression Stress Test
Procedure: The patient is supine. The examiner maximally plantarflexes the ankle and inverts the foot/heel. The posterior tibial nerve (behind the medial malleolus) is then compressed with fingers.
Duration: The position is held for 30 seconds.
Positive Result: Reproduction of symptoms, including numbness, paresthesia (tingling), or pain in the toes, ball of the foot, or heel
.
Clinical Value: This test has a reported sensitivity of 85.9% and a specificity of 100%, making it excellent for confirming tarsal tunnel syndrome
Royal London Hospital Test
Royal London Hospital Test
Purpose: To diagnose Achilles tendon pain
Procedure: The clinician palpates a tender spot on the Achilles tendon while the patient’s foot is relaxed (slightly plantarflexed), then checks the same spot while the patient dorsiflexes the foot.
Positive: If the pain is reduced or absent under dorsiflexion
Arc Sign
Position the Patient:
The patient lies on their stomach (prone) with their foot hanging off the table.
Palpate the Tendon:
The clinician gently squeezes the Achilles tendon (usually 2-6 cm above the heel) between their thumb and index finger, feeling for any localized swelling or thickening.
Perform Ankle Movement:
While the fingers remain on the swollen area, the patient actively moves their ankle from plantarflexion (pointing toes down) to dorsiflexion (pulling toes up).
Observe the Movement:
Positive Arc Sign (Tendinopathy): The palpable thickening or nodule moves along with the range of ankle motion.
Negative/Different Finding (Tendon Sheath Issue): The palpable swelling stays relatively still, sometimes with a gritty sensation (crepitus), suggesting paratendinitis (tendon sheath inflammation).
Lasegue Manuever
Lasegue Maneuver
Purpose: Assess for lumbar nerve root irritation (most commonly L4–S1), often due to disc herniation
Procedure: Passively raise the patient’s straight leg with the knee extended
Positive test: Reproduction of radicular leg pain (not just hamstring stretch)
