Thieme: Clinical Tests of the Musculoskeletal System

Home , Carpal tunnel syndrome, Drawer test, Galeazzi test

Contents VII Contents

1 Spine ...... 1 Range of Motion of the Spine (Neutral-Zero Method) ...... 3 Overview of Tests for Evaluating Spinal Function ...... 3 Fingertips-to-Floor Distance Test in Flexion ...... 6 Ott Sign ...... 7 Schober Sign ...... 7 Skin-Rolling Test (Kibler Fold Test) ...... 8 Chest Tests ...... 9 Sternum Compression Test ...... 9 Rib Compression Test ...... 9 Chest Circumference Test ...... 10 Schepelmann Test ...... 10 Cervical Spine Tests ...... 11 Cervical Spine—Range Of Motion—Screening (ROM) ...... 11 Screening of Cervical Spine Rotation ...... 12 Test of Head Rotation in Maximum Extension ...... 13 Test of Head Rotation in Maximum Flexion ...... 14 Test of Segmental Function in the Cervical Spine ...... 15 Soto–HallTest ...... 16 Percussion Test ...... 17 O’Donoghue Test ...... 17 Valsalva Test ...... 18 Spurling Test ...... 18 Cervical Spine Distraction Test ...... 19 Shoulder Press Test ...... 20 Brachial Plexus Tension Test ...... 21 Shoulder Abduction (Bakody) Test ...... 24 Test of Maximum Compression of the Intervertebral Foramina 24 Jackson Compression Test ...... 25 Intervertebral Foramina Compression Test ...... 26 Flexion Compression Test ...... 26 Extension Compression Test ...... 27 Thoracic Spine Tests ...... 27 Adams Forward Bend Test ...... 28 Kyphosis Test on Hands and Knees ...... 28

Test of Segmental Function in the Thoracic Spine in Extension and Flexion ...... 28 Lumbar Spine Tests ...... 29 Thomsen Sign—Prone Knee Flexion Test ...... 29 Spinous Process Tap Test ...... 30 Lhermitte’s Sign ...... 30 Psoas Sign ...... 31 Lasègue Drop (Rebound) Test ...... 32 One-Leg Standing (Stork Standing), Lumbar Extension Test .... 33 Lumbar Spine Springing Test ...... 34 Hyperextension Test ...... 34 Supported Forward Bend Test (Belt Test) ...... 35 Sacroiliac Joint ...... 36 Ligament Tests ...... 37 Springing Test 1 ...... 39 Patrick Test (Fabere Sign) ...... 40 Three-Phase Hyperextension Test ...... 41 Spine Test ...... 42 Standing Flexion Test ...... 43 Sacroiliac Mobilization Test ...... 45 Sacroiliac Joint Springing Test 2 ...... 46 Derbolowsky Sign ...... 47 Gaenslen Sign (2nd Mennell Sign) ...... 48 Iliac Compression Test ...... 49 1st Mennell Sign ...... 49 Yeoman Test ...... 50 Laguerre Test ...... 51 Sacroiliac Stress Test ...... 51 Abduction Stress Test ...... 52 Nerve Root Compression Syndrome ...... 52 Slump Test ...... 55 Lasègue Sign (Straight Leg Raising Test) ...... 56 Bonnet Sign (Piriformis Sign) ...... 58 Lasègue Test with the Patient Seated ...... 58 Bragard Test ...... 59 Lasègue Differential Test ...... 60 Duchenne Sign ...... 62 Kernig-Brudzinski Test ...... 62 Tiptoe and Heel Walking Test ...... 63 Femoral Nerve Traction Test ...... 64 Reverse Lasègue Test (Femoral Nerve Lasègue Test) ...... 65 Hoover Test ...... 67

2 Shoulder ...... 69 Range of Motion of the Shoulder (Neutral-Zero Method) ...... 71 Orientation Tests ...... 74 Quick Test of Combined Motion ...... 74 Codman Sign ...... 74 Palm Sign Test and Finger Sign Test ...... 76 Bursitis Tests ...... 76 Bursae ...... 76 Bursitis Sign ...... 77 DawbarnTest...... 77 Rotator Cuff (Impingement Symptoms) ...... 78 Zero-Degree Abduction Test ...... 81 Jobe Supraspinatus Test ...... 82 Subscapularis Test ...... 83 Gerber Lift-Off Test ...... 84 Belly Press–Abdominal Compression Test ...... 85 Napoleon Sign ...... 86 Infraspinatus Test ...... 87 Teres Test ...... 88 Abduction External Rotation Test ...... 88 Nonspecific Supraspinatus Test ...... 89 Drop Arm Test ...... 89 Walch Hornblower Sign ...... 90 Apley’s Scratch Test ...... 90 Painful Arc ...... 91 Neer Impingement Sign ...... 92 Hawkins and Kennedy Impingement Test ...... 93 Neer Impingement Injection Test ...... 94 Acromioclavicular Joint ...... 95 Painful Arc ...... 96 Crossed Body Adduction Stress Test ...... 97 Forced Adduction Test on Hanging Arm ...... 97 Clavicle Mobility Test ...... 98 Dugas Test ...... 98 Acromioclavicular Injection Test ...... 99 Long Head of the Biceps Tendon ...... 99 Nonspecific Biceps Tendon Test ...... 99 Abbott–Saunders Test ...... 100 Palm-Up Test (Speed Biceps or Straight Arm Test) ...... 101 Snap Test ...... 101

Yergason Test ...... 102 Hueter Sign ...... 102 Transverse Humeral Ligament Test ...... 103 Thompson and Kopell Horizontal Flexion Test (Cross-Body Action) ...... 104 Ludington Test ...... 105 Lippman Test ...... 105 SLAP Lesions ...... 106 O’Brien Active Compression Test ...... 106 Biceps Load Test 1 ...... 107 Biceps Load Test 2 ...... 108 Shoulder Instability ...... 109 Compression Test ...... 110 Anterior Apprehension Test ...... 110 Throwing Test ...... 114 Leffert Test ...... 114 Anterior and Posterior Load and Shift Test ...... 115 Gerber–Ganz Anterior Drawer Test ...... 115 Posterior Apprehension Test (Posterior Shift and Load Test) . . . 116 Gerber–Ganz Posterior Drawer Test ...... 116 Posterior Apprehension Test with the Patient Standing ...... 118 Fukuda Test ...... 119 Sulcus Sign ...... 119 RoweTest...... 121

3 Elbow ...... 123 Range of Motion of the Elbow (Neutral-Zero Method) ...... 126 Function Tests ...... 126 Orientation Tests ...... 126 Hyperflexion Test ...... 126 Supination Stress Test ...... 127 Stability Tests ...... 127 Ligamentous Instability ...... 127 Ligamentous Instability Test ...... 127 Posterolateral Rotary Instability Elbow Test (Pivot Shift Test) . . 128 Epicondylitis Tests ...... 129 Chair Test ...... 129 Bowden Test ...... 129 Thomson Test ...... 130

Mill Test ...... 131 Motion Stress Test ...... 131 Cozen Test ...... 132 Reverse Cozen Test ...... 133 Golfer’sElbowSign...... 134 Forearm Extension Test ...... 134 Compression Syndrome Tests ...... 135 Tinel Test ...... 135 Elbow Flexion Test ...... 135 Supinator Compression Test ...... 136

4 Wrist, Hand, and Fingers ...... 137 Range of Motion in the Hand (Neutral-Zero Method) ...... 138 Function Tests ...... 142 Tests of the Flexor Tendons of the Hand ...... 142 Flexor Digitorum Profundus ...... 142 Flexor Digitorum Superficialis ...... 142 Flexor Pollicis Longus and Extensor Pollicis Longus ...... 142 Muckard Test ...... 143 Finkelstein Test ...... 144 Grind Test ...... 145 Linburg Test ...... 145 Bunnell–Littler Test ...... 146 Watson Test (Scaphoid Shift Test) ...... 147 Scapholunate Ballottement Test ...... 148 Reagan Test (Lunotriquetral Ballottement Test) ...... 149 Finger Extension or “Shuck” Test...... 149 Dorsal Capitate Displacement Apprehension Test ...... 149 Supination Lift Test ...... 150 Stability Test for a Torn Ulnar Collateral Ligament in the Metacarpophalangeal Joint of the Thumb ...... 151 Compression Neuropathies of the Nerves of the Arm ...... 152 Pronator Teres Syndrome ...... 152 Compression Neuropathy of the Ulnar Nerve in Guyon’s Canal ...... 152 Carpal Tunnel Syndrome ...... 153 Cubital Tunnel Syndrome ...... 153 Tests of Motor Function in the Hand ...... 153 Testing the Pinch Grip ...... 153 Testing the Key Grip ...... 154 Testing the Power Grip ...... 155

Testing the Chuck Grip ...... 155 Testing Grip Strength ...... 155 Radial Nerve Palsy Screening Test ...... 155 Thumb Extension Test ...... 156 Supination Test ...... 157 Tinel Sign ...... 158 Median Nerve Palsy Screening Test ...... 158 Ochsner Test ...... 159 Carpal Tunnel Sign ...... 160 Phalen Test ...... 160 Nail Sign ...... 161 Bottle Test ...... 161 Reverse Phalen Test ...... 162 Pronation Test ...... 163 Froment Sign ...... 163 Ulnar Nerve Palsy Screening Test ...... 164 Intrinsic Test ...... 165 OTest ...... 165 Wrist Flexion Test ...... 166

5Hip...... 167 Function Tests ...... 169 Muscle Traction Test ...... 169 Fingertip Test ...... 172 Test for Rectus Femoris Contracture ...... 173 Hip Extension Test ...... 174 Iliotibial Tract Test ...... 174 Thomas Grip ...... 176 Noble Compression Test ...... 176 OberTest ...... 178 Piriformis Test ...... 180 Drehmann Sign ...... 181 Anvil Test ...... 182 Leg Pain upon Axial Compression ...... 183 Trendelenburg Sign/Duchenne Sign ...... 183 Anteversion Test ...... 185 Fabere Test (Patrick Test) for Legg–Calvé–Perthes Disease ..... 186 Telescope Sign ...... 187 Barlow and Ortolani Tests ...... 188 Galeazzi Test ...... 189 Leg Length Difference Test ...... 190 Hip and Lumbar Rigidity in Extension ...... 192

Trochanter Irritation Sign ...... 193 Posterior Margin Test ...... 193 Anterior Femoroacetabular Impingement Test ...... 194 Kalchschmidt Hip Dysplasia Tests ...... 195

6 Knee ...... 198 Range of Motion in the Knee (Neutral-Zero Method) ...... 199 Knee Swelling ...... 202 Brush (Stroke, Wipe) Test ...... 202 Dancing Patella Test ...... 203 Patella ...... 203 Patellar Chondropathy (Chondromalacia, Anterior Knee Pain) . 203 Q-Angle Test ...... 204 Glide Test ...... 205 Zohlen Sign ...... 206 Facet Tenderness Test ...... 207 Crepitation Test ...... 208 Fairbank Apprehension Test ...... 208 McConnell Test ...... 209 Subluxation Suppression Test ...... 211 Tilt Test ...... 212 Mediopatellar Plica Test ...... 213 Hughston Plica Test ...... 213 Dreyer Test ...... 214 Meniscus ...... 214 Apley Distraction and Compression Test (Grinding Test) ...... 215 McMurray Test (Fouche Sign) ...... 215 Bragard Test ...... 217 Payr Sign ...... 218 Payr Test ...... 218 Steinmann I Sign ...... 220 Steinmann II Sign ...... 221 Boehler–Kroemer Test ...... 222 Merke Test ...... 223 Cabot Test ...... 223 Finochietto Sign ...... 225 Childress Sign ...... 226 Turner Sign ...... 226 Anderson Medial and Lateral Compression Test ...... 227 Paessler Rotational Compression Test ...... 228

Tschaklin Sign ...... 230 Wilson Test ...... 230 Knee Ligament Stability Tests ...... 231 Abduction and Adduction Test (Valgus and Varus Stress Test) . . 231 Function Tests to Assess the Anterior Cruciate Ligament ...... 232 Lachman Test ...... 232 Prone Lachman Test ...... 234 Stable Lachman Test ...... 235 No-Touch Lachman Test ...... 235 Active Lachman Test ...... 236 Anterior Drawer Test in 90° Flexion ...... 238 Jakob Maximum Drawer Test ...... 240 Pivot Shift Test ...... 241 Jakob Graded Pivot Shift Test ...... 242 Modified Pivot Shift Test ...... 244 Medial Shift Test ...... 246 Soft Pivot Shift Test ...... 247 Martens Test ...... 248 Losee Test ...... 248 Slocum Test ...... 249 Arnold Crossover Test ...... 250 Noyes Test ...... 251 Jakob Giving Way Test ...... 252 Lemaire Test ...... 252 Hughston Jerk Test ...... 253 Function Tests to Assess the Posterior Cruciate Ligament ...... 254 Posterior Drawer Test in 90° Flexion (Posterior Lachman Test) . 254 Reversed Jakob Pivot Shift Test ...... 255 Quadriceps Contraction Test ...... 256 Posterior Drop Test ...... 257 Soft Posterolateral Drawer Test ...... 257 Gravity Sign and Genu Recurvatum Test ...... 258 Hughston Test for Genu Recurvatum and External Rotation . . . 259 Godfrey Test ...... 260 Dynamic Posterior Shift Test ...... 261 Loomer Posterolateral Rotary Instability Test ...... 261

7 Lower Leg, Ankle, and Foot ...... 263 Range of Motion in the Ankle and Foot (Neutral-Zero Method) . . 264 Function Tests ...... 266 Grifka Test ...... 266 Strunsky Test ...... 268 Toe Displacement Test ...... 268 Crepitation Test ...... 269 Metatarsal Tap Test ...... 269 Thompson Compression Test (Calf Compression Test) ...... 270 Hoffa Sign ...... 271 Achilles Tendon Tap Test ...... 272 Coleman Block Test ...... 272 Foot Flexibility Test ...... 273 Forefoot Adduction Correction Test ...... 274 Collateral and Syndesmosis Ligaments ...... 275 Talar Tilt Test 1 (Inversion Stress Test or Varus Stress Test) . . . 275 Talar Tilt Test 2 (Eversion Stress Test or Valgus Stress Test) . . . 276 Anterior Drawer Test ...... 277 External Rotation Stress Test (Kleiger Test) ...... 278 Squeeze Test ...... 279 Dorsiflexion Test ...... 279 Heel Thump Test ...... 280 Posterior Ankle Impingement Test—Hyperplantar Flexion Test 280 Anterior Ankle Impingement Test—Hyperdorsiflexion Test .... 282 Gaenslen Maneuver ...... 282 Mulder Click Test (Morton Test) ...... 282 Digital Nerve Stretch Test ...... 283 Heel Compression Test ...... 284 Tinel Sign ...... 284 Tourniquet Sign ...... 285

8 Posture Deficiency ...... 286 Kraus–Weber Tests ...... 287 Matthiass Postural Competence Tests ...... 289

9 Venous Thrombosis ...... 291 LowenbergTest...... 292 Trendelenburg Test ...... 293 Perthes Test ...... 293 Homans Test ...... 295

10 Occlusive Arterial Disease ...... 296 Allen Test ...... 297 George Vertebral Artery Test (De Klyn Test) ...... 297 Ratschow-Boerger Test ...... 298 Thoracic Outlet Syndrome ...... 299 Costoclavicular Test ...... 300 Hyperabduction Test ...... 301 Intermittent Claudication Test ...... 301 Adson Test ...... 302 Allen Maneuver ...... 302 Hemiparesis ...... 304 Arm-Holding Test ...... 304 Leg-Holding Test ...... 305

References ...... 306

Index ...... 315