Abductor Pollicis Brevis 5, 66, 68 Acetabular Dysplasia 199 Achilles

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Index

abductor pollicis brevis 5, 66, 68 dislocation 156 acetabular dysplasia 199 paediatric patients 205 achilles tendinitis 165 shoulder instability 99, 101, 207 achilles tendon 167 apprentice’s spine (thoraco-lumbar Scheuermann’s disruption 182 disease) 214 acromegaly 4 arachnodactyly 207 acromioclavicular joint arcade of Frohse 73 impingement signs/tests 96–97 arcade of Struthers 71 inspection 85 arthrogryposis multiplex congenita 191, 206 palpation 85, 88 ataxic gait 197 acromioclavicular joint disorders 81 axillary nerve damage 88, 114, 118 impingement 96, 97 axonotmesis 66 adolescent acetabular dysplasia 193 adolescent disc syndrome 213, 217 back kneeing 197 adolescent idiopathic scoliosis 197 back pain 125, 126 Adson’s manoeuvre 131 paediatric patients 214 Allen’s test 5, 19 ballotment test (Reagan) 35, 36 anconeous epitrochlearis 71 Barlow’s test 203 ankle 165–187 belly press test (Napoleon’s sign) 91, 95 anatomy 170, 173 benign essential tremor 4 examination 167–182 biceps brachii 117 history 165 function testing 92 inspection 167 rupture instability 165, 182 insertion tendon 46, 47 movement 176–179 long head 47, 85 muscle strength grading 206 biceps reflex 88 neurovascular assessment 180 bicipital tendonitis 88, 92 paediatric examination 205–206 biro test see tactile adherence test cerebral palsy 209 block test 199, 200, 201 pain 165 Blount’s disease 193 palpation 167 Bouchard’s nodes 13 special tests 182 Boutonniere deformity 17–18 symptoms 165–166 classification 17–18 terminology 186, 187 thumb 18, 19 ankylosing spondylitis 126, 127 bow-string test 131 antalgic gait 139, 197 bowlegs see genu varum anterior apprehension test, shoulder instability 99, 101 brachial plexus anterior cruciate ligament instability 150, 205 anatomy 107, 108 specific tests 156–157 relationships 107 anterior cruciate ligament tear 150, 205 neural topography 107 anterior drawer test, ankle instability 182 sensory distribution of roots/trunks/nerves 113 anterior interosseous syndrome 71 brachial plexus injury anterior talofibular ligament 167, 182 electrical studies 121 anterior-posterior drawer test, shoulder instability 99, examination 108–120 100 coexisting injuries 108, 109 Apert’s syndrome 21 immediate post-trauma 108–109 aplastic (Fanconi) anaemia 21 motor 114–118 apprehension test sensory 109–114 elbow instability 57, 58 imaging investigations 121 hip labral pathology 144–145 late stage 121 patellar pathology MRC grading of sensation 114

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220 Advanced Examination Techniques in Orthopaedics Index 221

brachial plexus injury – continued clicking hip 138 hand disorders 9 symptoms 43 root lesions 118 clicking shoulder 82 maternal 191 ulnar nerve assessment 71–73 shoulder weakness 82, 83 clinodactyly 207 peripheral nerve disorders 63 elbow flexion test 72 surgery 121 clubbing 5, 207 dial test 158, 159, 160 elbow impingement, provocation tests 54–55 brachialis 117 Coleman block test 184, 185, 206 dimple sign 37 elbow instability 43, 55–57 brachialis reflex 88 collagen disorders 99 disc protrusion/prolapse apprehension signs 57, 58 brachioradialis 117 colour, hand 4–5 cervical 125, 127 rotatory 55–56 Bryant’s triangle 141, 142, 202 peripheral nerve disorders 63 lumbar 126, 131 valgus 55 bursae 149 compression test paediatric patient 193 varus 55 carpal (lunotriquetral ligament) instability 37 thoracic 126 electrical resistance, upper limb nerve disorders 65 distal radioulnar joint 37 discitis 193, 213, 215 electromyography 66 café-au-lait spots 194, 195, 216 congenital dislocation of hip 138, 197, 203 discoid meniscus 204 suprascapular nerve entrapment 83 calcaneal apophysitis (Sever’s disease) 206 late presentation 193 Disk-criminator 66 Ely’s test 144 calcaneal disorders 169, 176 congenital elbow dislocation 207 distal interphalangeal (DIP) joint empty can test 88, 90 insufficiency fracture 165 congenital hand disorders 4, 5 flexor tendon injury 9, 11 endocrinopathies, foot problems 165 stress fracture 169 congenital hemivertebrae 213 movement 8 enophthalmos 107 calcaneofibular ligament injury 167 congenital short femur 205 osteoarthritis 13 extensor carpi radialis brevis 44 calcaneonavicular bar 184 congenital syphilis 191 distal radioulnar joint 37 extensor carpi radialis longus 44 calcaneus gait 197 congenital vertical talus 206 dividers 4 extensor carpi ulnaris subluxation 37 calcific tendonitis, acute 81 Constant score 99, 102 Down’s syndrome 194 extensor digiti quinti proprius (EDQ) sign 15, 16 camptodactyly 207 coxa vara 138, 197 drawer tests extensor digitorum brevis manus 27 capitellar injury 45 crank test 97 midcarpal instability 35 external rotation lag sign 89, 91 carpal boss 27 crouch gait 197 posterior cruciate ligament instability 159 external rotation recurvatum test 159 carpal instability 32 cubital tunnel syndrome 71 postero-lateral rotatory 57, 159 external rotator function testing 89 midcarpal 35 provocative tests 72–73, 74, 75 radiocarpal 35 ulnar-sided pain 35, 37 curly lesser toes 206 radioulnar 37 facet joint arthrosis 127 carpal tunnel syndrome 44, 63 shoulder instability 99, 100 factitious hand trauma 4 flexor synovitis 15, 16 drop sign 89, 92 Fanconi anaemia (aplastic anaemia) 21 median nerve assessment 66–67, 68 daylight sign 173 Duchenne muscular dystrophy 206 fascioscapulohumeral dystrophy 83, 92 symptoms 63 De Quervain’s disease 26, 28 Dupuytren’s disease 5, 19 femoral stretch test 133 carpometacarpal joint Finkelstein’s test 31, 33 fibromyalgia 127 movement 8 dead arm syndrome 82 finger osteoarthritis 13, 14 deep peroneal nerve entrapment 182 effusions, knee 149–150, 151 abduction 118, 120 cauda equina syndrome 126 deformity paediatric patients 204 adduction 118, 120 cavo-varus deformity 166, 182, 216 foot, acquired 166 Ehlers-Danlos syndrome 216 deformities 207 cerebellar ataxia 197 hand 3, 5 elbow 43–58 extension 117–118 cerebral palsy 206, 208, 214, 216 fingers 207 axial alignment 50–51 flexion 118, 119 lower limb assessment 208–209 peripheral nerve disorders 63 carrying angle 50, 51, 207 Finichietto-Bunnel test 16, 17 transpelvic pelvic obliquity 217 paediatric patients 191, 193 examination 44–57 Finkelstein’s test 31, 33 cervical myelopathy 125, 131 spinal see spinal deformity anterior aspect 45–47 flat foot see pes planus cervical plexus palsy 107 degenerative disc disease inspection 44 flexor hallucis longus cervical radiculopathy 82, 83 cervical spine 125–126, 127 lateral aspect 44–45 disruption 167 cervical spine inspection 127 medial aspect 47–48 tendinitis 165 degenerative disease 125–126, 127 lumbar spine 126, 131 palpation 44–50 flip test 131, 133 extension 84, 88 spinal movement assessment 127 posterior aspect 48–50 floppy baby 193, 215 flexion 84, 88 see also disc protrusion/prolapse extension 50, 51 foot 165–187 movement assessment 127, 128 degenerative elbow joint disease 43, 44 muscle function assessment 117 acquired deformity 166 neurovascular examination 128 radiocapitellar joint 45 flexion 50, 51 cerebral palsy 209 paediatric trauma 213 deltoid 118 muscle function assessment 116–117 examination 167–182 special tests 131 functional assessment 88, 114–115 forearm rotation 51 inspection 167 symptoms referable to elbow 43 dermatomal distributions 130 history 43–44 palpation 167 Charcot-Marie-Tooth disease (hereditary motor and lower limb 130 median nerve assessment 67–71 special tests 182 sensory neuropathy type I) 182, 184 upper limb 64 movement 50–52 history 165 Chopart’s joint 169 developmental milestones 191 paediatric examination 207 movement 176–179, 180, 181 claw hand 63 diabetes mellitus previous medical history 43 muscle strength grading 206 distal ulnar nerve lesions 72 Charcot neuroarthropathy 165 provocation tests 47, 53–57 neurovascular assessment 180 clawed toes 166, 184, 206 foot disorders 165, 166, 167 rotational deformity 51–52 paediatric examination 205–206 cleidocranial dysostosis 206 frozen shoulder 83 strength assessment 53 pain 165

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220 Advanced Examination Techniques in Orthopaedics Index 221 brachial plexus injury – continued clicking hip 138 hand disorders 9 symptoms 43 root lesions 118 clicking shoulder 82 maternal 191 ulnar nerve assessment 71–73 shoulder weakness 82, 83 clinodactyly 207 peripheral nerve disorders 63 elbow flexion test 72 surgery 121 clubbing 5, 207 dial test 158, 159, 160 elbow impingement, provocation tests 54–55 brachialis 117 Coleman block test 184, 185, 206 dimple sign 37 elbow instability 43, 55–57 brachialis reflex 88 collagen disorders 99 disc protrusion/prolapse apprehension signs 57, 58 brachioradialis 117 colour, hand 4–5 cervical 125, 127 rotatory 55–56 Bryant’s triangle 141, 142, 202 peripheral nerve disorders 63 lumbar 126, 131 valgus 55 bursae 149 compression test paediatric patient 193 varus 55 carpal (lunotriquetral ligament) instability 37 thoracic 126 electrical resistance, upper limb nerve disorders 65 distal radioulnar joint 37 discitis 193, 213, 215 electromyography 66 café-au-lait spots 194, 195, 216 congenital dislocation of hip 138, 197, 203 discoid meniscus 204 suprascapular nerve entrapment 83 calcaneal apophysitis (Sever’s disease) 206 late presentation 193 Disk-criminator 66 Ely’s test 144 calcaneal disorders 169, 176 congenital elbow dislocation 207 distal interphalangeal (DIP) joint empty can test 88, 90 insufficiency fracture 165 congenital hand disorders 4, 5 flexor tendon injury 9, 11 endocrinopathies, foot problems 165 stress fracture 169 congenital hemivertebrae 213 movement 8 enophthalmos 107 calcaneofibular ligament injury 167 congenital short femur 205 osteoarthritis 13 extensor carpi radialis brevis 44 calcaneonavicular bar 184 congenital syphilis 191 distal radioulnar joint 37 extensor carpi radialis longus 44 calcaneus gait 197 congenital vertical talus 206 dividers 4 extensor carpi ulnaris subluxation 37 calcific tendonitis, acute 81 Constant score 99, 102 Down’s syndrome 194 extensor digiti quinti proprius (EDQ) sign 15, 16 camptodactyly 207 coxa vara 138, 197 drawer tests extensor digitorum brevis manus 27 capitellar injury 45 crank test 97 midcarpal instability 35 external rotation lag sign 89, 91 carpal boss 27 crouch gait 197 posterior cruciate ligament instability 159 external rotation recurvatum test 159 carpal instability 32 cubital tunnel syndrome 71 postero-lateral rotatory 57, 159 external rotator function testing 89 midcarpal 35 provocative tests 72–73, 74, 75 radiocarpal 35 ulnar-sided pain 35, 37 curly lesser toes 206 radioulnar 37 facet joint arthrosis 127 carpal tunnel syndrome 44, 63 shoulder instability 99, 100 factitious hand trauma 4 flexor synovitis 15, 16 drop sign 89, 92 Fanconi anaemia (aplastic anaemia) 21 median nerve assessment 66–67, 68 daylight sign 173 Duchenne muscular dystrophy 206 fascioscapulohumeral dystrophy 83, 92 symptoms 63 De Quervain’s disease 26, 28 Dupuytren’s disease 5, 19 femoral stretch test 133 carpometacarpal joint Finkelstein’s test 31, 33 fibromyalgia 127 movement 8 dead arm syndrome 82 finger osteoarthritis 13, 14 deep peroneal nerve entrapment 182 effusions, knee 149–150, 151 abduction 118, 120 cauda equina syndrome 126 deformity paediatric patients 204 adduction 118, 120 cavo-varus deformity 166, 182, 216 foot, acquired 166 Ehlers-Danlos syndrome 216 deformities 207 cerebellar ataxia 197 hand 3, 5 elbow 43–58 extension 117–118 cerebral palsy 206, 208, 214, 216 fingers 207 axial alignment 50–51 flexion 118, 119 lower limb assessment 208–209 peripheral nerve disorders 63 carrying angle 50, 51, 207 Finichietto-Bunnel test 16, 17 transpelvic pelvic obliquity 217 paediatric patients 191, 193 examination 44–57 Finkelstein’s test 31, 33 cervical myelopathy 125, 131 spinal see spinal deformity anterior aspect 45–47 flat foot see pes planus cervical plexus palsy 107 degenerative disc disease inspection 44 flexor hallucis longus cervical radiculopathy 82, 83 cervical spine 125–126, 127 lateral aspect 44–45 disruption 167 cervical spine inspection 127 medial aspect 47–48 tendinitis 165 degenerative disease 125–126, 127 lumbar spine 126, 131 palpation 44–50 flip test 131, 133 extension 84, 88 spinal movement assessment 127 posterior aspect 48–50 floppy baby 193, 215 flexion 84, 88 see also disc protrusion/prolapse extension 50, 51 foot 165–187 movement assessment 127, 128 degenerative elbow joint disease 43, 44 muscle function assessment 117 acquired deformity 166 neurovascular examination 128 radiocapitellar joint 45 flexion 50, 51 cerebral palsy 209 paediatric trauma 213 deltoid 118 muscle function assessment 116–117 examination 167–182 special tests 131 functional assessment 88, 114–115 forearm rotation 51 inspection 167 symptoms referable to elbow 43 dermatomal distributions 130 history 43–44 palpation 167 Charcot-Marie-Tooth disease (hereditary motor and lower limb 130 median nerve assessment 67–71 special tests 182 sensory neuropathy type I) 182, 184 upper limb 64 movement 50–52 history 165 Chopart’s joint 169 developmental milestones 191 paediatric examination 207 movement 176–179, 180, 181 claw hand 63 diabetes mellitus previous medical history 43 muscle strength grading 206 distal ulnar nerve lesions 72 Charcot neuroarthropathy 165 provocation tests 47, 53–57 neurovascular assessment 180 clawed toes 166, 184, 206 foot disorders 165, 166, 167 rotational deformity 51–52 paediatric examination 205–206 cleidocranial dysostosis 206 frozen shoulder 83 strength assessment 53 pain 165

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222 Advanced Examination Techniques in Orthopaedics Index 223

foot – continued hand osteoarthritis 13 history 137 history 149–151 pain – continued pisotriquetral arthritis 37 movements 142–144 locking/pseudo-locking 150 forefoot 165–166 grip strength assessment 8, 38 abduction 143 movement assessment 154 hidfoot 165 gunstock deformity 207 adduction 144 paediatric examination 204–205 midfoot 165 extension 143 pain 149 symptoms 165–166 haemangioma 194 flexion 142–143 associated buckling 151 terminology 186, 187 haemarthrosis, knee 149, 150 rotation in extension 144 specific tests 154–160 forward bending test 127, 197 paediatric patients 204 rotation in flexion 144 ligament instability 156–160 Freiberg’s disease 170, 206 Haglund’s deformity 167 paediatric examination 202–204 meniscal pathology 154–155 Friedreich’s ataxia 206, 216 hallux rigidus 179 Hoffman’s sign 131 patello-femoral pathology 155–156 Froment’s sign 73, 74, 120 cheilus 170, 179 Holt-Oram syndrome 21 knock-knees see genu valgum frozen shoulder 81, 83, 88 grind test 179 Horner’s syndrome 107, 118 kyphosis 127, 213, 214, 216 primary/secondary 83 hallux valgus 166 brachial plexus injury 108, 109 full can test 88, 90 hamate fracture/non-union 37–38 clinical features 109 labral hip pathology 144–145 hammer toes 206 hug test 91, 95 labral tear, shoulder 82, 97 hand 3–22 humeral rotational deformity 52 Lachman’s test 156, 157, 205 Gage test 202, 208 colour 4–5, 63 hypothenar hammer syndrome 73 Lasègue’s sign 131 gait 139–140 examination 4–8 hysterical hand tremor 4 lateral collateral ligament 55 antalgic 139, 197 equipment 4 insufficiency 55 ataxic 197 flexor synovitis 16–18 iliopsoas power assessment 142–143 provocation tests 56, 57 calcaneus 197 flexor tendon injury 8–9, 10, 11, 12, 13 iliotibial band contracture 144, 209 lateral epicondylitis 44 crouch 197 Leddy classification 9, 10 immobility, hand skin creases 5 provocation tests 53 gluteus maximus 140 history 3–4 in-toeing gait 192, 193 lateral pivot shift test 56, 57 high stepping 197 instability 3–4 infection lateral plantar nerve entrapment 182 in-toeing 192, 193 ligamentous rupture 5 hand 3, 4 lateral ulnar collateral ligament 55 knee examination 151 movement 8 hip 137 latissimus dorsi, functional assessment 116 paediatric examination 191, 192–193, 194, 197 MRC muscle power scale 8, 9 spine 213 Leddy classification 9, 10 short leg 139–140, 197 osteoarthritis 3, 4, 5, 13, 14 inferior tibio-fibular syndesmosis injury 167, 172 leg length inequality 138, 167 spastic 197 paediatric examination 207 inflammation apparent shortening 140–141 spinal deformity 216 peripheral nerves examination see peripheral nerves elbow 43 infrapelvic pelvic obliquity 217 toe walking 197 examination hand 3, 4 knee assessment 154 Trendelenburg 140, 197 psoriatic arthritis 18–19, 20 knee 149–150 measurements 140–142 Galeazzi test 200, 201, 203 rheumatoid arthritis 13, 14 paediatric patients 204 Bryant’s triangle 141, 142 gamekeeper’s thumb 3 size 4 infraspinatus Nelaton’s line 141, 142 ganglion specific symptoms 3–4 function testing 89 Schoemaker’s line 141–142 foot 166 Harris hip score 137 wasting 83, 85 paediatric patients 193, 199, 200 hand 4 Heberden’s nodes 13 internal rotation lag sign 91, 94 postural/non-structural scoliosis 197 knee 149 hemihypertrophy 193 intersection syndrome (peritendinitis crepitans) 28 L’hermitte’s sign 131 paediatric patient 193, 207 hemivertebrae 213 intractable plantar keratosis 166 ligament of Struthers 67, 69 shoulder 85 hereditary multiple exostosis 193, 194, 206 inversion stress test 182 limp wrist 26, 207 hereditary sensorimotor neuropathy 193, 197, 206 irritable hip conditions 203 hip disease 137 Garrods nodes 19 type I (Charcot-Marie-Tooth disease) 182, 184 paediatric patients 191, 192–193, 197 gastro-soleus complex assessment 176 high stepping gait 197 Jamar dynamometer 4, 8, 38 Linburg Comstock sign 6 genu valgum 193, 194, 196 hip 137–145 lipoma, foot 166 genu varum 193, 194, 204 acute transient synovitis 192 Kiloh-Nevin sign 71 load and shift test 99 Gerber’s lift off test 91, 93 apprehesion test for labral pathology 144–145 Kirk Watson (scaphoid shift) test 32, 34 locking giant cell tumour of tendon sheath 4 arthritis 138, 143 Kirner deformity of little finger 207 elbow 43 giving way, knee 150–151 assessment scores 137 Klippel-Feil syndrome 206, 215 knee 150 glenohumeral arthritis 81 cerebral palsy 208 Klippel-Trenaunay syndrome 194 Louisiana State University Medical Centre grading system gluteus maximus chondrolysis 203 knee 149–160 114 gait 140 congenital dislocation 138, 197, 203 cerebral palsy 208–209 lower limb power assessment 143 late presentation 193 effusions 149–150, 151 alignment assessment 151, 152 goniometry 4 examination 138–142 examination 151–160 cerebral palsy 208–209 wrist 29, 31 gait 139–140 gait assessment 151 dermatomal distributions 130 gout 165 inspection 138 inspection 151, 152, 153 muscle innervation 130 Gower’s sign 197 leg length measurements 140–142 leg length discrepancy measurement 154 paediatric examination 199–206 grind test supine palpation 140 palpation 151, 153–154 root values 130 hallux rigidus 179 fixed flexion deformity 202, 203, 208 giving way 150–151 lumbar disc protrusion/prolapse 126, 131

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222 Advanced Examination Techniques in Orthopaedics Index 223 foot – continued hand osteoarthritis 13 history 137 history 149–151 pain – continued pisotriquetral arthritis 37 movements 142–144 locking/pseudo-locking 150 forefoot 165–166 grip strength assessment 8, 38 abduction 143 movement assessment 154 hidfoot 165 gunstock deformity 207 adduction 144 paediatric examination 204–205 midfoot 165 extension 143 pain 149 symptoms 165–166 haemangioma 194 flexion 142–143 associated buckling 151 terminology 186, 187 haemarthrosis, knee 149, 150 rotation in extension 144 specific tests 154–160 forward bending test 127, 197 paediatric patients 204 rotation in flexion 144 ligament instability 156–160 Freiberg’s disease 170, 206 Haglund’s deformity 167 paediatric examination 202–204 meniscal pathology 154–155 Friedreich’s ataxia 206, 216 hallux rigidus 179 Hoffman’s sign 131 patello-femoral pathology 155–156 Froment’s sign 73, 74, 120 cheilus 170, 179 Holt-Oram syndrome 21 knock-knees see genu valgum frozen shoulder 81, 83, 88 grind test 179 Horner’s syndrome 107, 118 kyphosis 127, 213, 214, 216 primary/secondary 83 hallux valgus 166 brachial plexus injury 108, 109 full can test 88, 90 hamate fracture/non-union 37–38 clinical features 109 labral hip pathology 144–145 hammer toes 206 hug test 91, 95 labral tear, shoulder 82, 97 hand 3–22 humeral rotational deformity 52 Lachman’s test 156, 157, 205 Gage test 202, 208 colour 4–5, 63 hypothenar hammer syndrome 73 Lasègue’s sign 131 gait 139–140 examination 4–8 hysterical hand tremor 4 lateral collateral ligament 55 antalgic 139, 197 equipment 4 insufficiency 55 ataxic 197 flexor synovitis 16–18 iliopsoas power assessment 142–143 provocation tests 56, 57 calcaneus 197 flexor tendon injury 8–9, 10, 11, 12, 13 iliotibial band contracture 144, 209 lateral epicondylitis 44 crouch 197 Leddy classification 9, 10 immobility, hand skin creases 5 provocation tests 53 gluteus maximus 140 history 3–4 in-toeing gait 192, 193 lateral pivot shift test 56, 57 high stepping 197 instability 3–4 infection lateral plantar nerve entrapment 182 in-toeing 192, 193 ligamentous rupture 5 hand 3, 4 lateral ulnar collateral ligament 55 knee examination 151 movement 8 hip 137 latissimus dorsi, functional assessment 116 paediatric examination 191, 192–193, 194, 197 MRC muscle power scale 8, 9 spine 213 Leddy classification 9, 10 short leg 139–140, 197 osteoarthritis 3, 4, 5, 13, 14 inferior tibio-fibular syndesmosis injury 167, 172 leg length inequality 138, 167 spastic 197 paediatric examination 207 inflammation apparent shortening 140–141 spinal deformity 216 peripheral nerves examination see peripheral nerves elbow 43 infrapelvic pelvic obliquity 217 toe walking 197 examination hand 3, 4 knee assessment 154 Trendelenburg 140, 197 psoriatic arthritis 18–19, 20 knee 149–150 measurements 140–142 Galeazzi test 200, 201, 203 rheumatoid arthritis 13, 14 paediatric patients 204 Bryant’s triangle 141, 142 gamekeeper’s thumb 3 size 4 infraspinatus Nelaton’s line 141, 142 ganglion specific symptoms 3–4 function testing 89 Schoemaker’s line 141–142 foot 166 Harris hip score 137 wasting 83, 85 paediatric patients 193, 199, 200 hand 4 Heberden’s nodes 13 internal rotation lag sign 91, 94 postural/non-structural scoliosis 197 knee 149 hemihypertrophy 193 intersection syndrome (peritendinitis crepitans) 28 L’hermitte’s sign 131 paediatric patient 193, 207 hemivertebrae 213 intractable plantar keratosis 166 ligament of Struthers 67, 69 shoulder 85 hereditary multiple exostosis 193, 194, 206 inversion stress test 182 limp wrist 26, 207 hereditary sensorimotor neuropathy 193, 197, 206 irritable hip conditions 203 hip disease 137 Garrods nodes 19 type I (Charcot-Marie-Tooth disease) 182, 184 paediatric patients 191, 192–193, 197 gastro-soleus complex assessment 176 high stepping gait 197 Jamar dynamometer 4, 8, 38 Linburg Comstock sign 6 genu valgum 193, 194, 196 hip 137–145 lipoma, foot 166 genu varum 193, 194, 204 acute transient synovitis 192 Kiloh-Nevin sign 71 load and shift test 99 Gerber’s lift off test 91, 93 apprehesion test for labral pathology 144–145 Kirk Watson (scaphoid shift) test 32, 34 locking giant cell tumour of tendon sheath 4 arthritis 138, 143 Kirner deformity of little finger 207 elbow 43 giving way, knee 150–151 assessment scores 137 Klippel-Feil syndrome 206, 215 knee 150 glenohumeral arthritis 81 cerebral palsy 208 Klippel-Trenaunay syndrome 194 Louisiana State University Medical Centre grading system gluteus maximus chondrolysis 203 knee 149–160 114 gait 140 congenital dislocation 138, 197, 203 cerebral palsy 208–209 lower limb power assessment 143 late presentation 193 effusions 149–150, 151 alignment assessment 151, 152 goniometry 4 examination 138–142 examination 151–160 cerebral palsy 208–209 wrist 29, 31 gait 139–140 gait assessment 151 dermatomal distributions 130 gout 165 inspection 138 inspection 151, 152, 153 muscle innervation 130 Gower’s sign 197 leg length measurements 140–142 leg length discrepancy measurement 154 paediatric examination 199–206 grind test supine palpation 140 palpation 151, 153–154 root values 130 hallux rigidus 179 fixed flexion deformity 202, 203, 208 giving way 150–151 lumbar disc protrusion/prolapse 126, 131

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224 Advanced Examination Techniques in Orthopaedics Index 225

lumbar discitis 193 metatarsus varus 206 developmental 191–192 patellar tap 204, 205 lumbar spine midcarpal drawer tests 35 prenatal 191 patello-femoral disorders 149 degenerative disease 126 midcarpal instability 35 limb length discrepancy 193 specific tests 155–156 examination midcarpal shift test 35 limp 191, 192–193, 197 pectoralis major, functional assessment 116 foot/ankle problems 167, 180 Monteggia fracture 207 lower limbs 199–206 pelvic obliquity 127, 138, 167, 216–217 neurovascular 128 Morton’s neuroma 166, 174 neuromuscular 208–209 infrapelvic 217 special tests 131–133 MRC muscle power grading 114 scoliosis 194 suprapelvic 217 movement assessment 127, 128 foot/ankle 206 spine 197–199, 213–217 transpelvic 217 spondylolisthesis 126, 127, 197, 199, 213 hand 8, 9 infant/very young child 215 peripheral nerve disorders dysplastic 217 MRC sensation grading 114 older child/adolescent 215–217 hand/upper limb 63–76 paediatric patients 214, 216 Mulder’s sign 174, 177 standing posture 194 dermatomes 64 lump sign 202 muscle power grading systems 8, 9, 114, 206 stiffness 191, 194 examination 63, 65 lunotriquetral ligament injury/instability 35 muscle wasting swelling 191, 193–194 history 63 lymphoedema, hand 4 hand 5, 63 symptoms 191, 192–194 investigations 66–76 shoulder 83, 85 upper limbs 206–207 objective clinical tests 65–67 McMurray’s test (modified) 154, 155 muscular dystrophy 82, 193, 214 weakness 191, 193 peripheral nerve territories 64 McMurty’s test 66, 68 musculocutaneous nerve 117 Paget’s disease 165 recovery assessment 65, 66 Madelung’s deformity 26, 207 myelomeningocele 138 pain potential for recovery 63 main en griffe deformity 4 myositis ossificans, elbow 46 ankle 165 specific symptoms 63 making a wish sign 73 back 125, 126, 213, 214 peritendinitis crepitans (intersection syndrome) 28 mallet toes 206 nails examination 5 discogenic peroneal muscular atrophy 206 Mannerfelt lesion 16 Napoleon’s sign (belly press test) 91, 95 arm (brachalgia) 125 peroneal tendinitis 165 Marfan’s syndrome 207 Neer’s impingement sign 92, 96 leg 126 peroneal tendon injury 167 Martin-Gruber anastomosis 73 Nelaton’s line 141, 142 elbow 43, 44, 54 dislocation 182 medial collateral ligament nerve conduction studies 66 foot 165 peroneus brevis 167, 173 instability tests 157–158 neurapraxia 66, 193 hand 3 peroneus longus 167, 174 strain 149 brachial plexus injury 110 peripheral nerve disorders 63 peroneus tertius 167 medial cruciate ligament strain 153 neurofibromatosis 193, 194, 195, 216 hip 137 Perthes disease 193, 202, 203–204 medial epicondylitis 44, 47, 48 neurogenic bladder 126, 127 knee 149 pes cavus 193, 194, 206 provocation tests 53–54 numbness associated buckling 151 paediatric patients 205 median nerve 118 hand 3, 63 neck 125 pes planus 169, 194 assessment tarsal tunnel syndrome 182 nerve root compression acquired 165, 166 at proximal forearm/elbow 67–71 cervical 125 flexible 193 at wrist 66–67 Ober’s test 144, 209 lumbar 126 paediatric patients 205, 206 brachial plexus topography 107 olecranon bursitis 50 thoracic 126 rigid 206 hand pathology 5 Ortolani test 203 upper limb 127 spasmodic peroneal 206 palpation 46 Osbourne’s fascia 71 paediatric patients 191 windlass effect 169, 175 territory 64, 113 Osgood-Schlatter’s disease 151, 204 spine 213, 214 Phalen’s test 47, 66 trauma 65 osteoarthritis shoulder 81 Phelp’s gracilis test 208 meniscal cyst 149, 151 hand 3, 4, 5, 13, 14 wrist 25 phrenic nerve meniscal tear 149, 150, 153 hip 143 ulnar-sided 35, 37 brachial plexus anatomical relationships 107 specific tests 154–155 shoulder 83, 88 painful arc 81 palsy 107 mesenchymal syndrome 44 osteoblastoma 214 paperclip-o-gram 19 piano key test 37, 38 metabolic bone disorders 193 osteochondral fracture 150 paraesthesia pigmented villo-nodular synovitis 151 metacarpophalangeal joint osteochondritis dissecans, elbow 43, 44 cervical spinal pathology 81, 125 pin prink test 66 flexor synovitis 16 osteogenesis imperfecta 194 hand 63 pin-wheel testing 4, 66 thumb 18 osteoid osteoma 214 tarsal tunnel syndrome 182 brachial plexus injury 110 movement 8 osteoporotic wedge fracture 127 Parkinson’s disease 4 pinch assessment 8 ostoearthritis 13, 14 overriding toes 206 Parsonage-Turner syndrome 81 pinch dynamometer 8 psoriatic arthritis 19, 20 Oxford hip score 137 patella pisotriquetral arthritis 37 rheumatoid arthritis 14 dislocation 150, 153, 155, 156 pivot shift test 35, 157 metatarsal overlength 166 paediatric examination 191–209 maltracking 155 plantar fasciitis 165, 169, 175 metatarsal stress fracture 170, 174 anthropometric measurements 194 paediatric patients 205 plantar fibromatosis 169 metatarsalgia 165, 166 communication skills 191 tendinosis 154 plantar keratosis 167, 173 metatarsophalangeal joint deformity 191, 193 tendon palpation 154 intractable 166 sesamoiditis 174 examination procedure 194–207 tilting 155–156 pointing sign 9, 10 synovitis 170, 173 gait abnormalities 191, 192–193, 195, 197 patellar apprehension test 156 Poland’s syndrome 21, 206 metatarsus adductus 206 history 191–192, 213 paediatric patients 205 poliomyelitis 209

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224 Advanced Examination Techniques in Orthopaedics Index 225 lumbar discitis 193 metatarsus varus 206 developmental 191–192 patellar tap 204, 205 lumbar spine midcarpal drawer tests 35 prenatal 191 patello-femoral disorders 149 degenerative disease 126 midcarpal instability 35 limb length discrepancy 193 specific tests 155–156 examination midcarpal shift test 35 limp 191, 192–193, 197 pectoralis major, functional assessment 116 foot/ankle problems 167, 180 Monteggia fracture 207 lower limbs 199–206 pelvic obliquity 127, 138, 167, 216–217 neurovascular 128 Morton’s neuroma 166, 174 neuromuscular 208–209 infrapelvic 217 special tests 131–133 MRC muscle power grading 114 scoliosis 194 suprapelvic 217 movement assessment 127, 128 foot/ankle 206 spine 197–199, 213–217 transpelvic 217 spondylolisthesis 126, 127, 197, 199, 213 hand 8, 9 infant/very young child 215 peripheral nerve disorders dysplastic 217 MRC sensation grading 114 older child/adolescent 215–217 hand/upper limb 63–76 paediatric patients 214, 216 Mulder’s sign 174, 177 standing posture 194 dermatomes 64 lump sign 202 muscle power grading systems 8, 9, 114, 206 stiffness 191, 194 examination 63, 65 lunotriquetral ligament injury/instability 35 muscle wasting swelling 191, 193–194 history 63 lymphoedema, hand 4 hand 5, 63 symptoms 191, 192–194 investigations 66–76 shoulder 83, 85 upper limbs 206–207 objective clinical tests 65–67 McMurray’s test (modified) 154, 155 muscular dystrophy 82, 193, 214 weakness 191, 193 peripheral nerve territories 64 McMurty’s test 66, 68 musculocutaneous nerve 117 Paget’s disease 165 recovery assessment 65, 66 Madelung’s deformity 26, 207 myelomeningocele 138 pain potential for recovery 63 main en griffe deformity 4 myositis ossificans, elbow 46 ankle 165 specific symptoms 63 making a wish sign 73 back 125, 126, 213, 214 peritendinitis crepitans (intersection syndrome) 28 mallet toes 206 nails examination 5 discogenic peroneal muscular atrophy 206 Mannerfelt lesion 16 Napoleon’s sign (belly press test) 91, 95 arm (brachalgia) 125 peroneal tendinitis 165 Marfan’s syndrome 207 Neer’s impingement sign 92, 96 leg 126 peroneal tendon injury 167 Martin-Gruber anastomosis 73 Nelaton’s line 141, 142 elbow 43, 44, 54 dislocation 182 medial collateral ligament nerve conduction studies 66 foot 165 peroneus brevis 167, 173 instability tests 157–158 neurapraxia 66, 193 hand 3 peroneus longus 167, 174 strain 149 brachial plexus injury 110 peripheral nerve disorders 63 peroneus tertius 167 medial cruciate ligament strain 153 neurofibromatosis 193, 194, 195, 216 hip 137 Perthes disease 193, 202, 203–204 medial epicondylitis 44, 47, 48 neurogenic bladder 126, 127 knee 149 pes cavus 193, 194, 206 provocation tests 53–54 numbness associated buckling 151 paediatric patients 205 median nerve 118 hand 3, 63 neck 125 pes planus 169, 194 assessment tarsal tunnel syndrome 182 nerve root compression acquired 165, 166 at proximal forearm/elbow 67–71 cervical 125 flexible 193 at wrist 66–67 Ober’s test 144, 209 lumbar 126 paediatric patients 205, 206 brachial plexus topography 107 olecranon bursitis 50 thoracic 126 rigid 206 hand pathology 5 Ortolani test 203 upper limb 127 spasmodic peroneal 206 palpation 46 Osbourne’s fascia 71 paediatric patients 191 windlass effect 169, 175 territory 64, 113 Osgood-Schlatter’s disease 151, 204 spine 213, 214 Phalen’s test 47, 66 trauma 65 osteoarthritis shoulder 81 Phelp’s gracilis test 208 meniscal cyst 149, 151 hand 3, 4, 5, 13, 14 wrist 25 phrenic nerve meniscal tear 149, 150, 153 hip 143 ulnar-sided 35, 37 brachial plexus anatomical relationships 107 specific tests 154–155 shoulder 83, 88 painful arc 81 palsy 107 mesenchymal syndrome 44 osteoblastoma 214 paperclip-o-gram 19 piano key test 37, 38 metabolic bone disorders 193 osteochondral fracture 150 paraesthesia pigmented villo-nodular synovitis 151 metacarpophalangeal joint osteochondritis dissecans, elbow 43, 44 cervical spinal pathology 81, 125 pin prink test 66 flexor synovitis 16 osteogenesis imperfecta 194 hand 63 pin-wheel testing 4, 66 thumb 18 osteoid osteoma 214 tarsal tunnel syndrome 182 brachial plexus injury 110 movement 8 osteoporotic wedge fracture 127 Parkinson’s disease 4 pinch assessment 8 ostoearthritis 13, 14 overriding toes 206 Parsonage-Turner syndrome 81 pinch dynamometer 8 psoriatic arthritis 19, 20 Oxford hip score 137 patella pisotriquetral arthritis 37 rheumatoid arthritis 14 dislocation 150, 153, 155, 156 pivot shift test 35, 157 metatarsal overlength 166 paediatric examination 191–209 maltracking 155 plantar fasciitis 165, 169, 175 metatarsal stress fracture 170, 174 anthropometric measurements 194 paediatric patients 205 plantar fibromatosis 169 metatarsalgia 165, 166 communication skills 191 tendinosis 154 plantar keratosis 167, 173 metatarsophalangeal joint deformity 191, 193 tendon palpation 154 intractable 166 sesamoiditis 174 examination procedure 194–207 tilting 155–156 pointing sign 9, 10 synovitis 170, 173 gait abnormalities 191, 192–193, 195, 197 patellar apprehension test 156 Poland’s syndrome 21, 206 metatarsus adductus 206 history 191–192, 213 paediatric patients 205 poliomyelitis 209

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226 Advanced Examination Techniques in Orthopaedics Index 227

polydactyly 207 radiocapitellar degenerative joint disease 45 seronegative arthropathies history 213 popliteal angle 208 radiocarpal drawer tests 35 foot problems 165, 206 see also scoliosis popliteal cyst 149 radioulnar drawer test 37 knee disorders 150 spinal dysraphism 182, 206, 216 posterior apprehension test, shoulder instability 99, 101 Reagan ballotment test 35, 36 serpentine foot deformity 206 external spinal markers 167, 194, 195, 215–216 posterior cruciate ligament rectus femoris contracture 144 serratus anterior 116 spinal infection 213 instability 205 relocations test, shoulder instability 99 Sever’s disease (calcaneal apophysitis) 206 spinal muscular atrophy 214 specific tests 158–160 restless legs 126 shear test 37 spine rupture 151 reverse Phalen’s test 66 short leg gait 139–140, 197 abnormalities associated with foot problems 165, 167 posterior drawer test reversed pivot shift test 159 shoulder 81–102 adult examination 125–133 posterior cruciate ligament instability 159 rheumatoid arthritis abduction 86, 88, 114–115 dermatomal distributions 130 shoulder instability 99, 100 elbow 43, 44, 50 adduction 116 history 125 posterior elbow impingement 44 foot/ankle 165, 166, 184 asymmetry 127 inspection 126–127 posterior interosseous syndrome 73, 75 forefoot 166 dislocation 81, 82, 83, 85 movement 127–128 provocative test 75, 76 metatarsophalangeal joint tenderness 173 elevation in scapular plane 87, 88 neurovascular examination 128 posterior Lachman test 159 hand 9, 13, 14 examination 83–85 palpation 127 posterior sag test 159 knee 150 documentation 100 special tests 131–133 posterior tibial nerve compression 167 shoulder 83, 85 inspection 83, 85 paediatric examination 213–217 posterior tibial tendinitis 165 wrist 26 paediatric patients 206–207 see also cervical spine; lumbar spine; thoracic spine posterior tibial tendon rupture 165, 167, 182 rhomboids 116 palpation 85 splinter haemorrhages 5 postero-lateral rotatory drawer test 57 functional assessment 114, 115 external rotation 87, 88 spondylolisthesis 126, 127, 197, 199, 213 postero-lateral rotatory instability of knee 158–160 Riche-Cannieu anastomosis 73 forward elevation 86, 88 dysplastic 217 postero-medial rotatory instability of knee 158 rickets 193 history 81 paediatric patients 214, 216 post-traumatic sympathetic dystrophy 5 rotational profile 202 impingement signs/tests 92 spondylosis posture rotator cuff disorders 81 instability 81–82, 98, 99, 100, 101, 207 cervical spine 125 elbow 44 tears 85 classification 81–82 paediatric patients 214 hand 4 tendonitis 81 testing 98, 99, 100, 101 sports injury hip examination 138 weakness 82 internal rotation 87, 88 elbow 44, 55 paediatric patients 194 rubella 191 lateral flexion 85, 88 hand flexor tendons 9 pronator teres syndrome 47, 67, 68–69 lateral rotation 85, 88 SLAP lesions 82 provocative tests 69–70 scaphoid lift test 33 movement assessment 88, 206 Sprengel’s shoulder 85, 206, 215 prone rectus femoris test 208 scaphoid pathology 26 glenohumeral/scapulothoracic differentiation 88, 89 Spurling’s manoeuvre 131 proprioception assessment, brachial plexus injury 111 scaphoid shift (Kirk Watson) test 32, 34 muscle testing 88–92 squeeze test proximal interphalangeal joint scaphoid thrust test 33 neurovascular assessment 88 distal tibiofibular syndesmosis assessment 167, 171 movement 8 scapholunate instability 32 power assessment 99–100, 102 metatarsophalangeal synovitis 173 psoriatic arthritis 19 scapular winging 85, 116 scapular stability assessment 116 Stahelis’ prone hip extension test 202, 208 pseudoachondroplasia 196 Scheuermann’s disease 127 subluxation 82 stenosing tenovaginitis of finges/thumb 44 pseudogout 165 lower thoracic (type I) 214, 216 symptoms 81–83 sternoclavicular joint inspection 85 psoriatic arthritis thoraco-lumbar (type II; apprentice’s spine) 214, 216 painful arc 81 stiffness foot/ankle problems 173 Schober’s Test 127, 128, 129, 217 shoulder abduction relief test 131 hand 4 hand 18–19 Schoemaker’s line 141–142 signe de clairon 91 hip 137 pulses, peripheral 128, 180 schwannoma 166 Silverskiold test 209 neck 125 sciatic nerve tension/irritation 131 sinus tarsi 167, 170 paediatric patients 191, 194 quadriceps active test 159 scoliosis 127, 194, 197, 213–214, 215, 217 size of hands 4 shoulder 83 cervico-thoracic 215 skew foot deformity 206 wrist 25 radial club hand 19, 21 classification 198 skin creases, hand examination 5 straight arm raising test 67 radial collateral ligament 55 infantile 213, 215 skin wrinkling (water immersion) test 5, 65 straight leg raising test 131, 132, 199, 208, 216 radial deviation 28, 30, 31 older child/adolescent 215, 216 SLAP (superior labrum anterior to posterior) lesions 82, crossover sign 133 radial head dislocation/fracture 45 idiopathic 197 97 knee assessment 154 radial malunion at wrist 26 postural/non-structural 197 slipped capital femoral epiphysis 192, 203 subacromial impingement 81, 92, 96 radial nerve 5, 117 structural 197 soft tissue sarcoma 193 subclavian vessel damage 107, 108 brachial plexus topography 107 suprapelvic pelvic obliquity 217 spastic gait 197 subscapularis function testing 91 compression Secretan’s disease 4 Speed’s test 92 subscapularis rupture 91 above elbow 73 Semmes Weinstein filaments 65, 66 spina bifida 205, 206, 209 subtalar joint irritation 167, 170, 206 below elbow (forearm) 73, 75 brachial plexus injury 111 spinal accessory nerve damage 107, 114 subungual glomus tumour 5 palsy 63 sensory examination spinal claudication 126 subungual melanoma 5 territory 64, 113 brachial plexus injury 109–114 spinal deformity 197–199, 213, 215 sulcus sign 98, 99 radial neuritis (Wartenberg’s neuralgia) 28 hand 5, 63 classification 198 superficial peroneal nerve entrapment 182 radial pulse 88, 131 MRC grading of sensation 114 forward bending test 197 superficial peroneal retinaculum injury 167, 182

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226 Advanced Examination Techniques in Orthopaedics Index 227 polydactyly 207 radiocapitellar degenerative joint disease 45 seronegative arthropathies history 213 popliteal angle 208 radiocarpal drawer tests 35 foot problems 165, 206 see also scoliosis popliteal cyst 149 radioulnar drawer test 37 knee disorders 150 spinal dysraphism 182, 206, 216 posterior apprehension test, shoulder instability 99, 101 Reagan ballotment test 35, 36 serpentine foot deformity 206 external spinal markers 167, 194, 195, 215–216 posterior cruciate ligament rectus femoris contracture 144 serratus anterior 116 spinal infection 213 instability 205 relocations test, shoulder instability 99 Sever’s disease (calcaneal apophysitis) 206 spinal muscular atrophy 214 specific tests 158–160 restless legs 126 shear test 37 spine rupture 151 reverse Phalen’s test 66 short leg gait 139–140, 197 abnormalities associated with foot problems 165, 167 posterior drawer test reversed pivot shift test 159 shoulder 81–102 adult examination 125–133 posterior cruciate ligament instability 159 rheumatoid arthritis abduction 86, 88, 114–115 dermatomal distributions 130 shoulder instability 99, 100 elbow 43, 44, 50 adduction 116 history 125 posterior elbow impingement 44 foot/ankle 165, 166, 184 asymmetry 127 inspection 126–127 posterior interosseous syndrome 73, 75 forefoot 166 dislocation 81, 82, 83, 85 movement 127–128 provocative test 75, 76 metatarsophalangeal joint tenderness 173 elevation in scapular plane 87, 88 neurovascular examination 128 posterior Lachman test 159 hand 9, 13, 14 examination 83–85 palpation 127 posterior sag test 159 knee 150 documentation 100 special tests 131–133 posterior tibial nerve compression 167 shoulder 83, 85 inspection 83, 85 paediatric examination 213–217 posterior tibial tendinitis 165 wrist 26 paediatric patients 206–207 see also cervical spine; lumbar spine; thoracic spine posterior tibial tendon rupture 165, 167, 182 rhomboids 116 palpation 85 splinter haemorrhages 5 postero-lateral rotatory drawer test 57 functional assessment 114, 115 external rotation 87, 88 spondylolisthesis 126, 127, 197, 199, 213 postero-lateral rotatory instability of knee 158–160 Riche-Cannieu anastomosis 73 forward elevation 86, 88 dysplastic 217 postero-medial rotatory instability of knee 158 rickets 193 history 81 paediatric patients 214, 216 post-traumatic sympathetic dystrophy 5 rotational profile 202 impingement signs/tests 92 spondylosis posture rotator cuff disorders 81 instability 81–82, 98, 99, 100, 101, 207 cervical spine 125 elbow 44 tears 85 classification 81–82 paediatric patients 214 hand 4 tendonitis 81 testing 98, 99, 100, 101 sports injury hip examination 138 weakness 82 internal rotation 87, 88 elbow 44, 55 paediatric patients 194 rubella 191 lateral flexion 85, 88 hand flexor tendons 9 pronator teres syndrome 47, 67, 68–69 lateral rotation 85, 88 SLAP lesions 82 provocative tests 69–70 scaphoid lift test 33 movement assessment 88, 206 Sprengel’s shoulder 85, 206, 215 prone rectus femoris test 208 scaphoid pathology 26 glenohumeral/scapulothoracic differentiation 88, 89 Spurling’s manoeuvre 131 proprioception assessment, brachial plexus injury 111 scaphoid shift (Kirk Watson) test 32, 34 muscle testing 88–92 squeeze test proximal interphalangeal joint scaphoid thrust test 33 neurovascular assessment 88 distal tibiofibular syndesmosis assessment 167, 171 movement 8 scapholunate instability 32 power assessment 99–100, 102 metatarsophalangeal synovitis 173 psoriatic arthritis 19 scapular winging 85, 116 scapular stability assessment 116 Stahelis’ prone hip extension test 202, 208 pseudoachondroplasia 196 Scheuermann’s disease 127 subluxation 82 stenosing tenovaginitis of finges/thumb 44 pseudogout 165 lower thoracic (type I) 214, 216 symptoms 81–83 sternoclavicular joint inspection 85 psoriatic arthritis thoraco-lumbar (type II; apprentice’s spine) 214, 216 painful arc 81 stiffness foot/ankle problems 173 Schober’s Test 127, 128, 129, 217 shoulder abduction relief test 131 hand 4 hand 18–19 Schoemaker’s line 141–142 signe de clairon 91 hip 137 pulses, peripheral 128, 180 schwannoma 166 Silverskiold test 209 neck 125 sciatic nerve tension/irritation 131 sinus tarsi 167, 170 paediatric patients 191, 194 quadriceps active test 159 scoliosis 127, 194, 197, 213–214, 215, 217 size of hands 4 shoulder 83 cervico-thoracic 215 skew foot deformity 206 wrist 25 radial club hand 19, 21 classification 198 skin creases, hand examination 5 straight arm raising test 67 radial collateral ligament 55 infantile 213, 215 skin wrinkling (water immersion) test 5, 65 straight leg raising test 131, 132, 199, 208, 216 radial deviation 28, 30, 31 older child/adolescent 215, 216 SLAP (superior labrum anterior to posterior) lesions 82, crossover sign 133 radial head dislocation/fracture 45 idiopathic 197 97 knee assessment 154 radial malunion at wrist 26 postural/non-structural 197 slipped capital femoral epiphysis 192, 203 subacromial impingement 81, 92, 96 radial nerve 5, 117 structural 197 soft tissue sarcoma 193 subclavian vessel damage 107, 108 brachial plexus topography 107 suprapelvic pelvic obliquity 217 spastic gait 197 subscapularis function testing 91 compression Secretan’s disease 4 Speed’s test 92 subscapularis rupture 91 above elbow 73 Semmes Weinstein filaments 65, 66 spina bifida 205, 206, 209 subtalar joint irritation 167, 170, 206 below elbow (forearm) 73, 75 brachial plexus injury 111 spinal accessory nerve damage 107, 114 subungual glomus tumour 5 palsy 63 sensory examination spinal claudication 126 subungual melanoma 5 territory 64, 113 brachial plexus injury 109–114 spinal deformity 197–199, 213, 215 sulcus sign 98, 99 radial neuritis (Wartenberg’s neuralgia) 28 hand 5, 63 classification 198 superficial peroneal nerve entrapment 182 radial pulse 88, 131 MRC grading of sensation 114 forward bending test 197 superficial peroneal retinaculum injury 167, 182

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228 Advanced Examination Techniques in Orthopaedics Index 229

superior gluteal nerve dysfunction 138 foot problems 166 ulnocarpal stress test 35, 36 weakness supracondylar fracture malunion 207 frozen shoulder 83 upper limb 38 hand 3, 63 suprascapular nerve entrapment 82, 83, 85 hand tremor 4 dermatomes 64, 130 paediatric patients 191, 193 supraspinatus 118 peripheral nerve disorders 63 muscle innervation 129 shoulder 82–83 functional assessment 88–89, 90, 114–115 tibialis anterior 167 paediatric examination 206–207 wrist 26 sural nerve entrapment 182 tibialis posterior 182, 183 peripheral nerves examination 63–76 Werdnig-Hoffman disease 191 swan neck deformity 14, 16–17 tendons assessment 176 root values 129 wet leather sign 28 classification 16 tenosynovitis 165 winging of scapula 85, 116 WOMAC Osteoarthritis Index 137 thumb 18 tibiocalcaneal angle 167, 168, 169 valgus elbow deformity 50 wrist 25–38 sweating abnormalities 107 Tinel’s sign 47, 48, 65, 69, 72, 131 valgus foot 165 examination 26–38 brachial plexus injury 111 brachial plexus injury 109, 110 valgus stress test 157, 158 inspection 26–28 hand 5, 207 toe deformities 206 Valleix phenomenon 166 paediatric 207 peripheral nerve disorders 63, 65 toe walking gait 197 varus elbow deformity 50 palpation 27, 28 sweating quantification 66 Tom Smith arthritis of infancy 200, 203 varus stress test 159 provocative tests 31–38 swelling too many toes sign 167, 182 vascular lesions, hand 4, 5, 8 range of motion 29–31 elbow 43 touch sensation vasculitis, foot problems 165 extension 29, 30, 117 foot/ankle 165 hand/upper limb 5, 65 Vaughan Jackson lesion 16 flexion 29, 30 hand 3, 4 shoulder 88 Vernier calliper 66 history 25–26 peripheral nerve disorders 63 tourniquet test 67 Vibration white finger 66 past medical history 26 knee 149–150, 204 transient hip synovitis, acute 192 vibrometry 66 pronation 31 paediatric patients 191, 193–194, 204 trapezius 116 Von Recklinghausen’s disease see neurofibromatosis wrist 26 functional assessment 114 supination 31 sympathetic nerves, brachial plexus anatomical trauma symptoms 25–26 relationships 107 brachial plexus examination see brachial plexus Wartenberg’s neuralgia (radial neuritis) 28 wrist drop 63 syndactyly 21–22, 207 elbow 43 Wartenburg sign 73, 75 wry neck 215 syphilis 191 hand 3, 5 water immersion test 5, 65 syrinx 216 peripheral nerve disorders 63, 65 Yergasson’s test 92 paediatric patients 191 table top test 19 tremor 4 tactile adherence test 5, 65 Trendelenburg gait 140, 197 talar coalition 165 Trendelenburg lurch 138 talocalcaneal bar 184 Trendelenburg test 138, 139, 199, 200 TAR syndrome (thrombocytopenia with absent radii) 19 delayed 138, 199 tarsal coalition 166, 184, 193, 206 triceps 117 tarsal tunnel syndrome 166, 180, 182 avulsion injury 48 telescoping test 203 partial tear 48 teres minor function testing 89 triceps reflex 88 thigh foot angle 201, 202 trigger finger/trigger thumb 9, 13 Thomas’s test 143, 202, 203, 208 Turner’s syndrome 206, 207 Thompson test 182 two point discrimination test thoracic outlet syndrome 131 brachial plexus injury 111, 112 thoracic spine hand/upper limb nerve injury 65–66 degenerative disease 126 movement assessment 127 ulnar collateral ligament 55 neurovascular examination 128 insufficiency 44, 55 thrombocytopenia with absent radii (TAR syndrome) 19 provocation tests 55, 56 thumb ulnar deviation 28, 30, 31 abduction 7, 118 ulnar nerve 118 adduction 7, 118 assessment Boutonniere deformity 18, 19 at elbow 71–73 extension 6, 117–118 at wrist 73 flexion 6, 118 brachial plexus topography 107 flexor synovitis 18 compression 43, 44, 47–48, 63 movement 6, 7, 8 hand pathology 5 opposition 8 palpation 47 swan neck deformity 18 proximal palsy 63 trigger 9, 13 territory 64, 113 thyroid disease ulnar tunnel syndrome 73

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228 Advanced Examination Techniques in Orthopaedics Index 229 superior gluteal nerve dysfunction 138 foot problems 166 ulnocarpal stress test 35, 36 weakness supracondylar fracture malunion 207 frozen shoulder 83 upper limb 38 hand 3, 63 suprascapular nerve entrapment 82, 83, 85 hand tremor 4 dermatomes 64, 130 paediatric patients 191, 193 supraspinatus 118 peripheral nerve disorders 63 muscle innervation 129 shoulder 82–83 functional assessment 88–89, 90, 114–115 tibialis anterior 167 paediatric examination 206–207 wrist 26 sural nerve entrapment 182 tibialis posterior 182, 183 peripheral nerves examination 63–76 Werdnig-Hoffman disease 191 swan neck deformity 14, 16–17 tendons assessment 176 root values 129 wet leather sign 28 classification 16 tenosynovitis 165 winging of scapula 85, 116 WOMAC Osteoarthritis Index 137 thumb 18 tibiocalcaneal angle 167, 168, 169 valgus elbow deformity 50 wrist 25–38 sweating abnormalities 107 Tinel’s sign 47, 48, 65, 69, 72, 131 valgus foot 165 examination 26–38 brachial plexus injury 111 brachial plexus injury 109, 110 valgus stress test 157, 158 inspection 26–28 hand 5, 207 toe deformities 206 Valleix phenomenon 166 paediatric 207 peripheral nerve disorders 63, 65 toe walking gait 197 varus elbow deformity 50 palpation 27, 28 sweating quantification 66 Tom Smith arthritis of infancy 200, 203 varus stress test 159 provocative tests 31–38 swelling too many toes sign 167, 182 vascular lesions, hand 4, 5, 8 range of motion 29–31 elbow 43 touch sensation vasculitis, foot problems 165 extension 29, 30, 117 foot/ankle 165 hand/upper limb 5, 65 Vaughan Jackson lesion 16 flexion 29, 30 hand 3, 4 shoulder 88 Vernier calliper 66 history 25–26 peripheral nerve disorders 63 tourniquet test 67 Vibration white finger 66 past medical history 26 knee 149–150, 204 transient hip synovitis, acute 192 vibrometry 66 pronation 31 paediatric patients 191, 193–194, 204 trapezius 116 Von Recklinghausen’s disease see neurofibromatosis wrist 26 functional assessment 114 supination 31 sympathetic nerves, brachial plexus anatomical trauma symptoms 25–26 relationships 107 brachial plexus examination see brachial plexus Wartenberg’s neuralgia (radial neuritis) 28 wrist drop 63 syndactyly 21–22, 207 elbow 43 Wartenburg sign 73, 75 wry neck 215 syphilis 191 hand 3, 5 water immersion test 5, 65 syrinx 216 peripheral nerve disorders 63, 65 Yergasson’s test 92 paediatric patients 191 table top test 19 tremor 4 tactile adherence test 5, 65 Trendelenburg gait 140, 197 talar coalition 165 Trendelenburg lurch 138 talocalcaneal bar 184 Trendelenburg test 138, 139, 199, 200 TAR syndrome (thrombocytopenia with absent radii) 19 delayed 138, 199 tarsal coalition 166, 184, 193, 206 triceps 117 tarsal tunnel syndrome 166, 180, 182 avulsion injury 48 telescoping test 203 partial tear 48 teres minor function testing 89 triceps reflex 88 thigh foot angle 201, 202 trigger finger/trigger thumb 9, 13 Thomas’s test 143, 202, 203, 208 Turner’s syndrome 206, 207 Thompson test 182 two point discrimination test thoracic outlet syndrome 131 brachial plexus injury 111, 112 thoracic spine hand/upper limb nerve injury 65–66 degenerative disease 126 movement assessment 127 ulnar collateral ligament 55 neurovascular examination 128 insufficiency 44, 55 thrombocytopenia with absent radii (TAR syndrome) 19 provocation tests 55, 56 thumb ulnar deviation 28, 30, 31 abduction 7, 118 ulnar nerve 118 adduction 7, 118 assessment Boutonniere deformity 18, 19 at elbow 71–73 extension 6, 117–118 at wrist 73 flexion 6, 118 brachial plexus topography 107 flexor synovitis 18 compression 43, 44, 47–48, 63 movement 6, 7, 8 hand pathology 5 opposition 8 palpation 47 swan neck deformity 18 proximal palsy 63 trigger 9, 13 territory 64, 113 thyroid disease ulnar tunnel syndrome 73