KNEE SPECIAL TEST

TESTS FOR POSITIVE SIGN INDICATION PROCEDURE

MENISCUS LESION
Dynamic Knee Test Pain at end of Lateral Meniscus • supinated
adduction Tear • flex knee to
90
• abd
• palpate lateral
meniscus
• add
Apley’s Test Increased rotation + Ligamentous Lesion • prone
pain during • flex knee to
distraction 90
Decreased rotation + Meniscus Injury • medial and
pain during lateral
compression rotation of
tibia +
distraction
• medial and
lateral
rotation of
tibia +
compression
Refractory or Retreating No meniscus Torn meniscus • supine
Test appearing = No • knee flexed to
rotation in Tibia 90
• palpate joint
line
• medial and
lateral
rotation of leg
(in and out)
McMurray’s Test Snap or clicking + Medial or Lateral • supine
pain Meniscus Lesions • knee flexed
(heel to butt)
• medially
rotate tibia
and extend
knee

repeat in different
ranges to test entire
posterior aspect of
the meniscus

TEST FOR SWELLING POSITIVE SIGN INDICATION PROCEDURE

Brush Test Wave of fluid Minimal swelling • supinated
 • stroke medial
side, upward
(3x)
Synovial Fluid: • stroke lateral
Normal: 1-7mL side,
Positive: 4-8mL downward
(3x)

GRADING
Zero No wave on
downstroke
Trace Small wave
on
downstroke
1+ Large wave
on
downstroke
2+ Fluid returns
medially after
upstroke
3+ So much
fluid
Patellar Tap Test Floating of Moderate swelling • Supinated
patella/dancing • Flex and
Synovial Fluid: Pronate knee
Positive: 40-50mL to discomfort
• Test
discomfort leg
• Apply slight
pressure on
patella
• Tap
TEST FOR POSITIVE SIGN INDICATION PROCEDURE
PATELLOFEMORAL
DYSFUNCTION
Step-up Test Inability to step up -Patellofemoral • Px stand on
sideways arthralgia (joint pain) stool
-Weak quadriceps • Step on stool
-Inability to stabilize (good leg)
pelvis • repeat on
other leg
OTHER TESTS POSITIVE SIGN INDICATION PROCEDURE
Q-angle Females - Greater Greater than 18 • supinated
than 18 Degrees degrees • foot on
neutral
Males - Lesser than -Chondromalacia position
13 Degrees patellae • gonio bitch
-Subluxing patella
Increased femoral
anteversion
 -Genu valgum
-Lateral
Displacement of
Tubercle
-Increased lateral
tibial torsion

Lesser than 13
Degrees

-Chondromalacia
patellae
-Patella Alta

TEST FOR POSITIVE SIGN INDICATION

OSTEOCHONDRITIS
DISSECANS
Wilson Test Pain in flexion then Osteochondritis • sitting on
Pain disappears in Dissecans knee flexed
lateral rotation over
examining
table
• actively
extended and
medial
rotation
• laterally rotate

LEG, ANKLE, AND FOOT SPECIAL TEST

TEST TO POSITIVE SIGN INDICATION PROCEDURE
DETERMINE
POSITION OF
TALUS
Talar Neutral Position Asymmetry When asymmetry • stand
(weight bearing) remains – Structural • palpate talus
Asymmetry • laterally rotate
trunk (left and
When Asymmetry right)
disappears –
functional asymmetry
TEST FOR POSITIVE SIGN INDICATION PROCEDURE
ALIGNMENT
Foot-heel alignment Medial side of foot is Forefoot Valgus
raised
TEST FOR TIBIAL POSITIVE SIGN INDICATION PROCEDURE
TORSION
“Too many toes” Sign In valgus, more -Hyperpronation • stand
 laterally rotated than -Tibial and Lateral
normal femoral torsion
TEST FOR POSITIVE SIGN INDICATION PROCEDURE
LIGAMENTOUS
INSTABILITY
Talar Tilt Pain during Inversion -Torn calcaneofibular • side-lying
ligament • slightly flex
- Anterior talofibular knee
ligament • apply eversion
and inversion
Pain during Eversion -Torn deltoid ligament stress in talus
-tibiocalcaneal
-tibionavicular
-posterior
tibiotalar
ligaments
TEST FOR JOINT POSITIVE SIGN INDICATION PROCEDURE
INSTABILITY
External Rotation Pain over anterior and Syndesmosis/ high • seated
Stress Test posterior tibiofibular ankle injury • stabilize leg
ligament with one hand
• other hand
Pain medially and Tear of deltoid holds foot in
displacement in talus ligament heel (below)
from medial malleolus • apply passive
lateral rotation
stress
TEST FOR THIRD- POSITIVE SIGN INDICATION PROCEDURE
DEGREE STRAIN
RUPTURE
Thompson’s Absence of plantar Achilles tendon • pronated
Simmonds Test flexion rupture • squeeze calf
muscle
TEST FOR POSITIVE SIGN INDICATION PROCEDURE
SWELLING
Figure Eight Excessive difference Swelling • long sitting
measurement in measurement • figure 8
• repeat three
times, take the
average