SPECIAL TESTS

NPTE Final Frontier

Supplementary Material
Pinky Yadav
SHOULDER JOINT
YERGASON’S TEST
▶ PURPOSE- Integrity of transverse ligament

▶ DESCRIPTION- Patient sitting with elbow flexed to 90° and

stabilized against the thorax and with the forearm
pronated. Resist the supination of forearm and external
rotation of shoulder

▶ RESULT- Tendon of long head of biceps will pop out of the START POSITION

groove. Tenderness in the bicipital groove alone without the

dislocation may indicate bicipital paratenonitis/tendinosis

END POSITION
SPEED’S TEST
▶ PURPOSE- Identify bicipital tendinosis/ tendinopathy

▶ DESCRIPTION- Upper limb in full extension and forearm

supinated, resist shoulder flexion. Alternate – place
shoulder in 90 degree flexion and push upper limb into
extension

▶ RESULT- Pain in long head of biceps tendon/ increased

tenderness in the bicipital groove
NEER’S IMPINGEMENT TEST
▶ PURPOSE- For impingement of supraspinatus and
biceps tendon

▶ DESCRIPTION- The patient’s arm is passively and

forcibly fully elevated in the scapular plane with the arm
medially rotated by the examiner. This passive stress
causes the greater tuberosity to jam against the
anteroinferior border of the acromion

▶ RESULT- Reproduces symptoms of pain in the shoulder

region
EMPTY CAN/ JOBE TEST
▶ PURPOSE- Identify tear/ impingement of supraspinatus
tendon or suprascapular nerve neuropathy

▶ DESCRIPTION- The patient’s arm is abducted to 90°

with neutral (no) rotation, and the examiner provides
resistance to abduction. The shoulder is then medially
rotated and angled forward 30° (“empty can” position)
so that the patient’s thumbs point toward the floor in the
plane of the scapula. Differentiate if pain is present
between two positions

▶ RESULT- Reproduces pain in supraspinatus tendon

or weakness in empty can position
DROP ARM TEST
▶ PURPOSE- Also known as Codman’s test. Identify tear/
full rupture of rotator cuff

▶ DESCRIPTION- The examiner abducts the patient’s

shoulder to 90° and then asks the patient to slowly
lower the arm to the side in the same arc of movement

▶ RESULT- A positive test is indicated if the patient

is unable to return the arm to the side slowly or
has severe pain when attempting to do so
POSTERIOR INTERNAL IMPINGEMENT TEST

▶ PURPOSE- To identify impingement between rotator

cuff and greater tuberosity or posterior glenoid and labrum

▶ DESCRIPTION- The patient is placed in the supine

lying position. The examiner passively abducts the
shoulder to 90° to 110°, with 15° to 20° extension and
maximum lateral rotation

▶ RESULT- Reproduction of pain in posterior shoulder

during test
HAWKINS-KENNEDY IMPINGEMENT
TEST
▶ PURPOSE: Identify sub-acromial impingement

▶ DESCRIPTION: The arm of the patient is passively flexed up to 90 degrees in the

plane of the scapula. The arm is stabilized and the forearm is forced into IR

▶ RESULT: Pain indicates a positive test for supraspinatus paratenonitis/tendinosis or

secondary impingement

▶ The Yocum test is a modification of this test in which the

patient’s hand is placed on the opposite shoulder and the
examiner elevates the elbow. Pain indicates a positive test

YOCUM
ACTIVE COMPRESSION TEST OF O’BRIEN
▶ PURPOSE: To detect SLAP (Type II) or superior labral lesions

▶ DESCRIPTION: Two-part test. The patient stands with his or her involved shoulder at
90 degrees of flexion, 10 degrees of horizontal adduction, and maximum IR with the
elbow in extension. In this position, the patient then resists a downward force applied
by the clinician to the distal arm. The test is then repeated in the same manner
except that the arm is positioned in maximum ER.

▶ RESULT: If pain on the joint line or painful clicking is produced inside the shoulder
(not over the acromioclavicular joint) in the first part of the test and eliminated or
decreased in the second part, the test is considered
positive for labral abnormalities.
BICEPS LOAD TEST
▶ PURPOSE: To check the integrity of the superior labrum.

▶ DESCRIPTION: The patient is supine or seated with the shoulder abducted to 120°
and laterally rotated with the elbow flexed to 90° and the forearm supinated. The
examiner performs an apprehension test on the patient by taking the arm into full
lateral rotation. If apprehension appears, the examiner stops lateral rotation and
holds the position. The patient is then asked to flex the elbow against the examiner’s
resistance at the wrist.

▶ RESULT: If apprehension decreases or the patient

feels more comfortable, the test is negative for a
SLAP lesion. If the apprehension remains the same or
the shoulder becomes more painful, the test is considered
positive for SLAP lesions
PAIN PROVOCATION (MIMORI) TEST
▶ PURPOSE: To identify SLAP lesion

▶ DESCRIPTION: The patient is seated and the arm is abducted to between 90° and
100°, and the examiner laterally rotates the arm by holding the wrist. The forearm is
taken into maximum supination and then maximum pronation.

▶ RESULT: If pain is provoked only in the pronated position

or if the pain is more severe in the pronated position,
the test is considered positive for a superior (SLAP) tear.
LATERAL ROTATION LAG SIGN
▶ PURPOSE: To test the teres minor and infraspinatus. Also known as Infraspinatus
“Spring Back” Test.

▶ DESCRIPTION: The patient is seated or in standing position with the arm by the side
and the elbow flexed to 90°. The examiner passively abducts the arm to 90° in the
scapular plane, laterally rotates the shoulder to end range and asks the patient to
hold it

▶ RESULT: For a positive test, the patient cannot hold the position and the hand
springs back anteriorly toward midline, indicating infraspinatus and teres minor
cannot hold the position due to weakness or
pain
ABDOMINAL COMPRESSION TEST
▶ PURPOSE: Checks the subscapularis muscle. Also k/a Belly-Press or Napoleon Test

▶ DESCRIPTION: The patient is standing, examiner places a hand on the abdomen

below the xiphoid process so that the examiner can feel how much pressure the
patient is applying to the abdomen. The patient places his hand of the shoulder being
tested on the examiner’s hand and pushes the hand as hard as he can into the
stomach (medial shoulder rotation). While pushing the hand into the abdomen, the
patient attempts to bring the elbow forward to the scapular plane, causing greater
medial shoulder rotation.

▶ RESULT: If the patient is unable to maintain the pressure on

the examiner’s hand while moving the elbow forward, or
posteriorly flexes the wrist or extends the shoulder, the test
is positive for a tear of the subscapularis muscle
JERK TEST
▶ PURPOSE: To test recurrent posterior instability

▶ DESCRIPTION: The patient sits with the arm medially rotated and forward flexed to
90°. The examiner grasps the patient’s elbow and axially loads the humerus in a
proximal direction. While maintaining the axial loading, the examiner moves the arm
horizontally across the body

▶ RESULT: A positive test is the production of a sudden jerk or clunk as the humeral
head slides off (subluxes) the back of the glenoid. When
the arm is returned to the original 90° abduction position, a
second jerk may be felt as the head reduces.
SULCUS SIGN
▶ PURPOSE: To test for inferior shoulder instability

▶ DESCRIPTION: The patient stands with the arm by the side and shoulder muscles
relaxed. The examiner grasps the patient’s forearm below the elbow and pulls the
arm distally

▶ RESULT: The presence of a sulcus sign may indicate inferior instability or

glenohumeral laxity but should only be considered positive for instability if the patient
is symptomatic
PECTORALIS MAJOR CONTRACTURE
TEST
▶ PURPOSE: To identify tightness of pectoralis major muscle

▶ DESCRIPTION: The patient lies supine and clasps the hands together behind the
head. The arms are then lowered until the elbows touch the examining table

▶ RESULT: A positive test occurs if the elbows do not reach the table and indicates a
tight pectoralis major muscle.
HALSTEAD MANEUVER
▶ PURPOSE: Identify pathology of structures that pass through thoracic inlet

▶ DESCRIPTION: The examiner finds the radial pulse and applies a downward traction
on the test extremity while the patient’s neck is hyperextended and the head is
rotated to the opposite side

▶ RESULT: Absence or disappearance of a pulse indicates

a positive test for thoracic outlet syndrome.
CLUNK TEST
▶ PURPOSE- Identifies glenoid labrum tear

▶ DESCRIPTION- Patient is supine, with shoulder in full abduction. Push humeral head
anteriorly, while rotating humerus externally

▶ RESULT- Audible clunk is heard while performing test

ANTERIOR APPREHENSION/CRANK
TEST
▶ PURPOSE- Identify past anterior dislocation of shoulder

▶ DESCRIPTION- Patient supine, the examiner abducts the arm to 90° and laterally
rotates the patient’s shoulder slowly. By placing a hand under the glenohumeral joint
to act as a fulcrum, the apprehension test becomes the fulcrum test

▶ RESULT- Patient does not allow or does not like to move shoulder into that direction
to simulate anterior dislocation

FULCRUM TEST
POSTERIOR APPREHENSION SIGN
▶ PURPOSE- To identify past history of posterior
shoulder dislocation

▶ DESCRIPTION- Patient supine/ sitting. The examiner

elevates the patient’s shoulder in the plane of the
scapula to 90° while stabilizing the scapula with the
other hand, then applies a posterior force on the patient’s
elbow. While applying the axial load, the examiner
horizontally adducts and medially rotates the arm.

▶ RESULT- RESULT- Patient does not allow or does not

like to move shoulder into that direction to simulate
posterior dislocation
ACROMIOCLAVICULAR SHEAR TEST
▶ PURPOSE- Identifies dysfunction of AC joint
such as arthritis, separation

▶ DESCRIPTION- With the patient in the sitting

position, the examiner cups his or her hands
over the deltoid muscle with one hand on the
clavicle and one hand on the spine of the
scapula. The examiner then squeezes the heels
of the hands together

▶ RESULT- Reproduces pain in AC joint

ADSON’S TEST
▶ PURPOSE- Identify pathology of structures that
pass through thoracic inlet

▶ DESCRIPTION-The examiner locates the radial

pulse. The patient’s head is rotated to face the
test shoulder. The patient then extends the head
while the examiner laterally rotates and extends
the patient’s shoulder. The patient is instructed to
take a deep breath and hold it.

▶ RESULT- A disappearance of the pulse

indicates a positive test.
COSTOCLAVICULAR SYNDROME
(MILITARY BRACE) TEST
▶ PURPOSE- Identify pathology of structures that
pass through thoracic inlet

▶ DESCRIPTION-The examiner palpates the radial

pulse and then draws the patient’s shoulder down
and back

▶ RESULT- A positive test is indicated by an absence

of the pulse and implies possible thoracic outlet
syndrome (costoclavicular syndrome). This test is
particularly effective in patients who complain of
symptoms while wearing a backpack or heavy coat.
WRIGHT (HYPERABDUCTION) TEST
▶ PURPOSE- Identify pathology of structures that
pass through thoracic inlet

▶ DESCRIPTION- Patient sitting, locate radial pulse

of the extremity being tested. Move shoulder into
maximum abduction and external rotation.
Taking deep breath and rotating head opposite to
test site may accentuate symptoms.

▶ RESULT- Neurological/ vascular symptoms

(disappearance of pulse) will be reproduced

Allen
maneuver
ROOS TEST
(ELEVATED ARM STRESS TEST)
▶ PURPOSE- Identify pathology of structures that
pass through thoracic inlet

▶ DESCRIPTION- The patient stands and abducts

the arms to 90°, laterally rotates the shoulder, and
flexes the elbows to 90° so that the elbows are
slightly behind the frontal plane. The patient then
opens and closes the hands slowly for 3 minutes

▶ RESULT- If the patient is unable to keep the arms

in the starting position for 3 minutes or suffers
ischemic pain, heaviness or profound weakness of the
arm, or numbness and tingling of the hand during the
minutes, the test is considered positive for thoracic outlet
syndrome on the affected side.
UPPER LIMB TENSION TESTS
UPPER LIMB TENSION TESTS
ELBOW JOINT
LIGAMENT INSTABILITY TEST
▶ PURPOSE- To identify ligament laxity or restriction

▶ DESCRIPTION- Patient sitting or supine, elbow placed in 20 to 0 degree of flexion.

Valgus force placed through elbow tests ulnar collateral ligament. Varus force tests
radial collateral ligament.

▶ RESULT-Primary finding is laxity but pain may be present.

LATERAL EPICONDYLITIS TEST
▶ Also known as Tennis elbow test/ Cozen’s test

▶ PURPOSE- Identify lateral epicondylopathy

▶ DESCRIPTION- The patient is sitting with elbow 90 degree flexion then asked to
actively make a fist, pronate the forearm, and radially deviate and extend the wrist
while the examiner resists the motion.

▶ RESULT- Sudden severe pain in the area of the lateral epicondyle of

the humerus is a positive sign
MILL’S TEST
▶ PURPOSE- Identify lateral epicondylopathy

▶ DESCRIPTION- While palpating the lateral epicondyle, the examiner passively

pronates the patient’s forearm, flexes the wrist fully, and extends the elbow

▶ RESULT- Pain over the lateral epicondyle of the humerus indicates a positive test.
MAUDSLEY’S TEST
▶ PURPOSE- Identify lateral epicondylopathy

▶ DESCRIPTION- The examiner resists extension of the third digit of the hand distal to
the proximal interphalangeal joint, stressing the extensor digitorum muscle and
tendon

▶ RESULT- Positive test is indicated by pain over the lateral epicondyle of the humerus
ELBOW FLEXION TEST
▶ PURPOSE- Identify cubital tunnel syndrome

▶ DESCRIPTION- The patient is asked to fully flex the elbow with extension of the wrist
and shoulder girdle abduction (90°) and depression and to hold this position for 3 to 5
minutes. Symptoms should develop in less than 5 seconds

▶ RESULT- Tingling or paresthesia in the ulnar nerve distribution of the forearm and
hand indicates a positive test. The test helps to determine whether a cubital tunnel
(ulnar nerve) syndrome is present.
MEDIAL EPICONDYLITIS TEST
▶ PURPOSE- Identify medial epicondylopathy (Golfer’s elbow test)

▶ DESCRIPTION- While the examiner palpates the patient’s medial epicondyle, the
patient’s forearm is passively supinated and the examiner extends the elbow and
wrist.

▶ RESULT- A positive sign is indicated by pain over the medial epicondyle of the
humerus
TINEL’S SIGN
▶ PURPOSE- Identifies dysfunction of ulnar nerve at olecranon

▶ DESCRIPTION- The area of the ulnar nerve in the groove is tapped.

▶ RESULT- A positive sign is indicated by a tingling sensation in the ulnar distribution

of the forearm and hand distal to the point of compression of the nerve. The test
indicates the point of regeneration of the sensory fibers of a nerve. The most distal
point at which the patient feels the abnormal
sensation represents the limit of nerve regeneration.
PRONATOR TERES SYNDROME TEST
▶ PURPOSE- Identify median nerve entrapment within pronator teres

▶ DESCRIPTION- The patient sits with the elbow flexed to 90°. The examiner strongly
resists pronation as the elbow is extended

▶ RESULT- Tingling or paresthesia in the median nerve distribution in the forearm

and hand indicates a positive test.
WRIST JOINT
FINKELSTEIN’S TEST
▶ PURPOSE- Determine the presence of de Quervain disease, a paratenonitis in the
thumb

▶ DESCRIPTION- The patient makes a fist with the thumb inside the fingers. The
examiner stabilizes the forearm and deviates the wrist toward the ulnar side.

▶ RESULT- Pain over the abductor pollicis longus and extensor pollicis brevis tendons
at the wrist and is indicative of a paratenonitis of these two tendons.
BUNNEL- LITTLER TEST
▶ PURPOSE- Identifies tightness in structures surrounding the MCP joint

▶ DESCRIPTION- The metacarpophalangeal joint is held slightly extended while

the examiner moves the proximal interphalangeal joint into flexion, if possible.

▶ RESULT- If the test is positive (which is indicated by inability to flex the proximal
interphalangeal joint), there is a tight intrinsic muscle or contracture of the joint
capsule. If the metacarpophalangeal joints are slightly flexed, the proximal
interphalangeal joint flexes fully if the intrinsic muscles are tight, but it does not flex
fully if the capsule is tight. The patient remains passive during the test. This test is
also called the intrinsic-plus test
TIGHT RETINACULAR TEST
▶ PURPOSE- Identify tightness around PIP joint

▶ DESCRIPTION- The proximal interphalangeal joint is held in a neutral position while

the distal interphalangeal joint is flexed by the examiner. If the distal interphalangeal
joint does not flex, the retinacular (collateral) ligaments or proximal interphalangeal
capsule are tight. If the proximal interphalangeal joint is flexed and the distal
interphalangeal joint flexes easily, the retinacular ligaments are tight and the capsule
is normal.
LIGAMENT INSTABILITY TEST
▶ PURPOSE- Identify ligament instability, medial or lateral

▶ DESCRIPTION- Fingers are stabilized and supported. Varus or valgus stress applied
to the joint (proximal or distal interphalangeal) to test the integrity of the collateral
ligaments

▶ RESULT- The results are compared for laxity with those of the uninvolved hand,
which is tested first.
FROMENT’S SIGN
▶ PURPOSE- Identify ulnar nerve dysfunction

▶ DESCRIPTION- The patient attempts to grasp a piece of paper between the thumb
and index finger

▶ RESULT- When the examiner attempts to pull away the paper, the terminal phalanx
of the thumb flexes because of paralysis of the adductor pollicis muscle, indicating a
positive test. If, at the same time, the metacarpophalangeal joint of the thumb
hyperextends, the hyperextension is noted as a positive Jeanne’s sign. Both tests, if
positive, are indicative of ulnar nerve paralysis
WARTENBERG SIGN
▶ PURPOSE- Identify ulnar nerve neuropathy

▶ DESCRIPTION- The patient sits with his or her hands resting on the table. The
examiner passively spreads the fingers apart and asks the patient to bring them
together again.

▶ RESULT- Inability to squeeze the little finger to the remainder of the hand indicates a
positive test for ulnar neuropathy
HOFFMAN’S SIGN
▶ PURPOSE- Indicates upper motor neuron dysfunction

▶ DESCRIPTION- The examiner holds the patient’s middle finger and briskly flicks the
distal phalanx

▶ RESULT- A positive sign is noted if the interphalangeal joint of the thumb of the same
hand flexes/adducts. The fingers may also flex.
THUMB GRIND TEST
▶ PURPOSE- Identify degenerative joint disease in the metacarpophalangeal or
metacarpotrapezial joint

▶ DESCRIPTION- The examiner holds the patient’s hand with one hand and grasps the
patient’s thumb below the metacarpophalangeal joint with the other hand. The
examiner then applies axial compression and rotation to the metacarpophalangeal
joint

▶ RESULT- If pain is elicited, the test is positive and

indicative of degenerative joint disease in the
metacarpophalangeal or metacarpotrapezial joint
MURPHY'S SIGN
▶ PURPOSE- Identify lunate dislocation

▶ DESCRIPTION- The patient is asked to make a fist. If the head of the third
metacarpal is level with the second and fourth metacarpals, the sign is positive and
indicative of a lunate dislocation. Normally, the third metacarpal would project beyond
(or further distally) the second and fourth metacarpals.
TINEL’S SIGN
▶ PURPOSE-Identify carpal tunnel compression of median nerve

▶ DESCRIPTION- The examiner taps over the carpal tunnel at the wrist

▶ RESULT- A positive test causes tingling or paresthesia into the thumb, index finger,
and middle and lateral half of the ring finger. Tinel sign at the wrist is indicative of a
carpal tunnel syndrome.
PHALEN’S TEST
▶ PURPOSE- Identify carpal tunnel compression of median nerve

▶ DESCRIPTION- The examiner flexes the patient’s wrists maximally and holds this
position for 1 minute by pushing the patient’s wrists together.

▶ RESULT- Production of the patient’s symptoms is considered to be a positive test for

carpal tunnel syndrome. The test may also involve flexing the wrist 60° before
applying the pressure and whether symptoms are relieved when the examiner lets
go. The wrist flexion is felt to make the test more sensitive
TWO POINT DISCRIMINATION TEST
▶ PURPOSE-To identify level of sensory innervation in hand

▶ DESCRIPTION- The examiner uses a paper clip, two-point discriminator, or calipers

to simultaneously apply pressure on two adjacent points in a longitudinal direction or
perpendicular to the long axis of the finger; the examiner moves proximal to distal in
an attempt to find the minimal distance at which the patient can distinguish between
the two stimuli. Only the fingertips need to be tested. Normal discrimination distance
recognition is less than 6 mm
ALLEN’S TEST
▶ PURPOSE- To identify vascular compromise

▶ DESCRIPTION- The patient is asked to open and close the hand several times as
quickly as possible and then squeeze the hand tightly. The examiner’s thumb and
index finger are placed over the radial and ulnar arteries, compressing them. The
patient then opens the hand while pressure is maintained over the arteries. One
artery is tested by releasing the pressure over that artery to see if the hand flushes.
The other artery is then tested in a similar fashion.
HIP JOINT
PATRICK’S (FABER) TEST
▶ PURPOSE- Identify hip dysfunction, such as mobility restriction

▶ DESCRIPTION- Patient lies supine. Passively flex, abduct and externally rotate hip
test leg so that the foot of the test leg is on top of the knee of the opposite leg. Slowly
lowers the knee of the test leg toward the examining table.

▶ RESULT- A negative test is indicated by the test leg’s

knee falling to the table or at least being parallel with the
opposite leg.
A positive test is indicated by the test leg’s knee
remaining above the opposite straight leg. Positive
the test indicates that the hip joint may be affected,
that there may be iliopsoas spasm, or that the sacroiliac
joint may be affected.
GRIND (Scouring) TEST
▶ PURPOSE- Identify DJD of hip joint

▶ DESCRIPTION- The patient lies supine. The examiner flexes and adducts the
patient’s hip so that the hip faces the patient’s opposite shoulder and resistance to
the movement is felt

▶ RESULT- May reproduce pain in hip joint and refer pain to knee or elsewhere
TRENDELENBURG SIGN
▶ PURPOSE- To identify weakness of gluteus medius or unstable hip joint.

▶ DESCRIPTION- The patient is asked to stand on one lower limb. Normally, the pelvis
on the opposite side should rise; this finding indicates a negative test

▶ RESULT- If the pelvis on the opposite side (non-stance side) drops when the patient
stands on the affected leg, a positive test is indicated.
THOMAS TEST
▶ PURPOSE- Identifies tightness of hip flexors

▶ DESCRIPTION- The patient lies supine while the examiner checks for excessive
lordosis, which is usually present with tight hip flexors. The examiner flexes one of
the patient’s hips, bringing the knee to the chest to flatten out the lumbar spine and to
stabilize the pelvis. The patient holds the flexed hip against the chest.

▶ RESULT- If there is no flexion contracture, the

hip being tested (the straight leg) remains on the
examining table. If a contracture is present, the
patient’s straight leg rises off the table and a
muscle stretch end feel will be felt
OBER’S TEST
▶ PURPOSE- To identify tightness of TFL/IT band

▶ DESCRIPTION- The patient is in the side lying position with the lower leg flexed at
the hip and knee for stability. The examiner then passively abducts and extends the
patient’s upper leg with the knee straight or flexed to 90°. The examiner
slowly lowers the upper limb

▶ RESULT- If a contracture is present, the leg remains abducted and

does not fall to the table.
ELY’S TEST
▶ PURPOSE- To identify tightness of rectus femoris.

▶ DESCRIPTION- The patient lies prone, and the examiner passively flexes the
patient’s knee

▶ RESULT- On flexion of the knee, the patient’s hip on the same side spontaneously
flexes, indicating that the rectus femoris muscle is tight on that side and that the test
is positive.
90-90 HAMSTRING TEST
▶ PURPOSE- Identify hamstring tightness

▶ DESCRIPTION- The supine patient flexes both hips to 90° while the knees are bent.
The patient may grasp behind the knees with both hands to stabilize the hips at 90°
of flexion. The patient actively extends each knee in turn as much as possible.

▶ RESULT- Positive if knee is unable to reach 10 degree from neutral position (lacking
10 degree of extension)
TRIPOD SIGN
▶ PURPOSE- Identifies tightness of hamstring muscle.

▶ DESCRIPTION- The patient is seated with both knees flexed to 90° over the edge of
the examining table. The examiner then passively extends one knee. If the hamstring
muscles on that side are tight, the patient extends the trunk to relieve the tension in
the hamstring muscles. The leg is returned to its starting position, and the other leg is
tested and compared with the first side. Extension of the spine is indicative of a
positive test.

▶ RESULT- Extension of the spine is indicative of a

positive test.
PIRIFORMIS TEST
▶ PURPOSE- Identifies piriformis syndrome

▶ DESCRIPTION- The patient is in the side lying position with the test leg uppermost.
The patient flexes the test hip to 60° with the knee flexed. The examiner stabilizes the
hip with one hand and applies a downward pressure to the knee

▶ RESULT- If the piriformis muscle is tight, pain is elicited in the muscle. If the piriformis
muscle is pinching the sciatic nerve, pain results in the buttock and sciatica may be
experienced by the patient
LEG LENGTH TEST
▶ PURPOSE- Identifies true leg length discrepancy

▶ DESCRIPTION- True leg length is measured by placing the patient in a supine

position with the ASISs level and the patient’s lower limbs perpendicular to the line
joining the ASISs. Using a flexible tape measure, the examiner obtains the distance
from the ASIS to the medial or lateral malleolus on the same side. The measurement
is repeated on the other side, and the results are compared.

▶ RESULT - A difference of 1 to 1.3 cm (0.5 to 1 inch) is considered normal.

CRAIG’S TEST
▶ PURPOSE- It is used to identify abnormal femoral anteversion

▶ DESCRIPTION- The patient lies prone with the knee flexed to 90°. The examiner
palpates the posterior aspect of the greater trochanter of the femur. The hip is then
passively rotated medially and laterally until the greater trochanter is parallel with the
examining table or reaches its most lateral position.

▶ RESULT- The degree of anteversion can then be estimated, based on the angle of
the lower leg with the vertical.
KNEE JOINT
COLLATERAL LIGAMENT
INSTABILITY TEST – LCL & MCL
▶ PURPOSE- To identify ligament laxity or restriction

▶ DESCRIPTION- Entire lower limb is supported and stabilized, knee placed in 20-30
degree of flexion. Valgus force placed through knee test MCL and varus force checks
LCL

▶ RESULT- Primary finding is laxity but pain may be reproduced

LACHMAN’S STRESS TEST
▶ PURPOSE- Indicates integrity of ACL

▶ DESCRIPTION- The patient lies supine with the involved leg beside the examiner.
The examiner holds the patient’s knee between full extension and 30° of flexion. The
patient’s femur is stabilized with one of the examiner’s hands (the “outside” hand)
while the proximal aspect of the tibia is moved forward with the other (“inside”) hand

▶ RESULT- A positive sign is indicated by a “mushy” or soft end feel when the tibia is
moved forward on the femur (increased anterior translation with medial rotation of the
tibia) and disappearance of the infrapatellar tendon slope
PIVOT SHIFT TEST
▶ PURPOSE- Indicates ACL integrity

▶ DESCRIPTION- The patient lies in the supine position with the clinician standing to
the side of the patient's involved knee. There are two main types of clinical tests to
determine the presence of the pivot shift: the reduction test and the subluxation test.

▶ Reduction test. The clinician stabilizes the patient's lower leg and flexes the knee to
90 degrees with one hand while using the palm of the other hand to medially rotate
the tibia, effectively subluxing the lateral tibial plateau. A sudden reduction of the
anteriorly subluxed lateral tibial plateau is seen as the pivot shift
PIVOT SHIFT TEST
▶ Subluxation test. This test is effectively the reverse of the reduction test. The test
begins with patient’s knees flexed. The clinician internally rotates the patient’s tibias
with one hand and applies a valgus stress to the knee joint with the other hand. The
clinician slowly extends the knee, maintaining rotation of the tibia. As the patient’s
knee reaches full extension, the tibial plateau will be felt to relocate.
POSTERIOR SAG TEST
▶ PURPOSE- Indicates PCL integrity

▶ DESCRIPTION- The patient lies supine with the hip flexed to 45° and the knee flexed
to 90°.

▶ RESULT- In this position, the tibia “drops back,” or sags back, on the femur because
of gravity if the posterior cruciate ligament is torn
SLOCUM TEST
▶ PURPOSE- To assess both anteromedial and anterolateral rotary instabilities

▶ DESCRIPTION- The patient’s knee is flexed to 80° or 90°, and the hip is flexed to
45°. The foot is first placed in 30° medial rotation. The examiner then sits on the
patient’s forefoot to hold the foot in position and draws the tibia forward; if the test is
positive, movement occurs primarily on the lateral side of the knee. This movement is
excessive relative to the unaffected side and indicates ALRI.
▶ In the second part of the test, the foot is placed in 15° of lateral
rotation, and the tibia is drawn forward by the examiner. If the
test is positive, the movement occurs primarily on the medial
side of the knee. This movement is excessive relative to the
unaffected side and indicates anteromedial rotary instability
POSTERIOR DRAWER TEST
▶ PURPOSE- Indicates integrity of PCL

▶ DESCRIPTION- Patient supine with testing hip flexed to 45 degree and knee flexed
to 90 degree. Passively glide tibia posteriorly following the joint plane

▶ RESULT- Excess posterior glide is positive finding

REVERSE LACHMAN TEST
▶ PURPOSE- Test for the posterior cruciate ligament integrity

▶ DESCRIPTION- The patient lies prone with the knee flexed to 30°, and the examiner
grasps the tibia with one hand while fixing the femur with the other hand. The
examiner then pulls the tibia up (posteriorly), noting the amount of movement and the
quality of the end feel.
McMURRAY’S TEST
▶ PURPOSE- Identifies meniscal tears

▶ DESCRIPTION- The patient lies in the supine position with

the knee completely flexed (the heel to the buttock). The
examiner then medially rotates the tibia and extends the knee

▶ RESULT- If there is a loose fragment of the lateral meniscus,

this action causes a snap or click that is often
accompanied by pain.

▶ Test medial meniscus with same procedure

except rotate tibia into lateral rotation
APLEY TEST
▶ PURPOSE- Help differentiate between meniscal tears and ligamentous lesion

▶ DESCRIPTION- The patient lies in the prone position with the knee flexed to 90°. The
patient’s thigh is then anchored to the examining table with the examiner’s knee. The
examiner medially and laterally rotates the tibia, combined first with distraction, while
noting any restriction, excessive movement, or discomfort. Then the process is
repeated using compression instead of distraction

▶ RESULT- If rotation plus distraction is more painful

or shows increased rotation relative to the normal
side, the lesion is probably ligamentous. If the
rotation plus compression is more painful or
shows decreased rotation relative to the normal
side, the lesion is probably a meniscus injury.
BOUNCE HOME TEST
▶ PURPOSE- Indicates meniscal lesion

▶ DESCRIPTION- The patient lies in the supine position, and the heel of the patient’s
foot is cupped in the examiner’s hand. The patient’s knee is completely flexed, and
the knee is passively allowed to extend. If extension is not complete or has a rubbery
end feel (“springy block”), there is something blocking full extension.

▶ RESULT- The most likely cause of a block is a torn meniscus.

THESSALY TEST
▶ PURPOSE- Indicates meniscal lesion

▶ DESCRIPTION- The patient stands flat footed on one leg while the examiner
provides his or her hands for balance. The patient then flexes the knee to 5° and
rotates the femur on the tibia medially and laterally three times while maintaining the
5° flexion. The good leg is tested first, and then the injured leg. The test is then
repeated at 20° flexion.

▶ RESULT- The test is considered positive for a meniscus tear if the patient
experiences medial or lateral joint line discomfort. The
patient may also have a sense of locking or catching in
the knee.
HUGHSTON’S PLICA TEST
▶ PURPOSE- Identify dysfunction of plica

▶ DESCRIPTION- The patient lies in the supine position, and the examiner flexes the
knee and medially rotates the tibia with one arm and hand while pressing the patella
medially with the heel of the other hand and palpating the medial femoral condyle
with the fingers of the same hand

▶ RESULT- The patient’s knee is passively flexed and extended while the examiner
feels for “popping” of the plica band under the fingers.
The popping indicates a positive test.
PATELLAR APPREHENSION TEST
▶ PURPOSE- Indicate past history of patella dysfunction

▶ DESCRIPTION- Patient supine, with patella passively glided laterally

▶ RESULT- – Patient does not allow the patella to move in lateral direction
CLARKE’S SIGN
▶ PURPOSE- Identify patellofemoral dysfunction

▶ DESCRIPTION- The examiner presses down slightly proximal to the base of the
patella with the web of the hand as the patient lies relaxed with the knee extended.
The patient is then asked to contract the quadriceps muscles while the examiner
pushes down.

▶ RESULT- If the patient can complete and maintain the contraction without pain, the
test is considered negative. If the test causes retropatellar pain and the patient
cannot hold a contraction, the test is considered positive.
BALLOTABLE PATELLA/ PATELLA
TAP TEST
▶ PURPOSE- Indicates infrapatellar effusion

▶ DESCRIPTION- With the patient’s knee extended or flexed to discomfort, the

examiner applies a slight tap or pressure over the patella

▶ RESULT- When this is done, a floating of the patella should be felt. This is
sometimes called the “dancing patella” sign
FLUCTUATION TEST
▶ PURPOSE- Indicates knee joint effusion

▶ DESCRIPTION- The examiner places the palm of one hand over the suprapatellar
pouch and the palm of the other hand anterior to the joint with the thumb and index
finger just beyond the margins of the patella

▶ RESULT- By pressing down with one hand and then the other, the examiner may feel
the synovial fluid fluctuate under the hands and move from one hand to the other,
indicating significant effusion
Q ANGLE MEASUREMENT
▶ The angle is obtained by first ensuring that the lower limbs are at a right angle to the
line joining the two ASISs. A line is then drawn from the ASIS to the midpoint of the
patella on the same side and from the tibial tubercle to the midpoint of the patella.
The angle formed by the crossing of these two lines is called the Q-angle.

▶ Normally, the Q-angle is 13° for males and 18° for

females when the knee is straight
NOBLE COMPRESSION TEST
▶ PURPOSE- Identifies distal IT band friction syndrome

▶ DESCRIPTION- The patient lies in the supine position, and the examiner flexes the
patient’s knee to 90°, accompanied by hip flexion. Pressure is then applied to the
lateral femoral epicondyle, or 1 to 2 cm (0.4 to 0.8 inch) proximal to it, with the thumb.
While the pressure is maintained, the patient’s knee is passively extended

▶ RESULT-. At approximately 30° of flexion (0° being straight leg), the patient
experiences severe pain over the lateral femoral condyle
TINEL’S SIGN
▶ PURPOSE- To identify dysfunction of common fibular nerve posterior to fibular head

▶ DESCRIPTION- Tap the region where common fibular nerve passes posterior to
fibular head

▶ RESULT- Reproduces tingling sensation or paresthesia in leg

ANKLE JOINT
NEUTRAL SUBTALAR POSITIONING
▶ PURPOSE- Identifies abnormal rearfoot to forefoot positioning

▶ DESCRIPTION- Patient prone with foot over edge of the table. Palpate dorsal aspect
of talus on both sides with one hand, and grasp lateral forefoot with other hand.
Gently dorsiflex foot until resistance then gently move foot through arc of supination
and pronation

▶ RESULT- Neutral position is where you feel foot fall off easier to one side or other. At
this point compare rearfoot to forefoot and rearfoot to leg.
ANTERIOR DRAWER TEST
▶ PURPOSE- Identify ligamentous instability (particularly anterior talofibular ligament)

▶ DESCRIPTION- The patient lies supine with the foot relaxed. The examiner stabilizes
the tibia and fibula, holds the patient’s foot in 20° of plantar flexion, and draws the
talus forward in the ankle mortise

▶ RESULT- Positive test if talus has excessive anterior

glide/ pain is noted
TALAR TILT TEST
▶ PURPOSE- To identify instability of calcaneofibular ligament.

▶ DESCRIPTION- The patient lies in the supine or side lying position with the foot
relaxed . The patient’s gastrocnemius muscle may be relaxed by flexion of the knee.
The foot is held in the anatomical (90°) position, talus is then tilted from side to side
into inversion and eversion.

▶ RESULT- Inversion tests the calcaneofibular ligament. Eversion stresses the deltoid
ligament
EXTERNAL ROTATION STRESS TEST
▶ PURPOSE- Evaluates syndesmosis injury and a tear of the deltoid ligament. Also
known as Kleiger test.

▶ DESCRIPTION- The patient is seated with the leg hanging over the examining table
with the knee at 90°. The examiner stabilizes the leg with one hand. With the other
hand, the examiner holds the foot in plantigrade (90°) and applies a passive lateral
rotation stress to the foot and ankle.

▶ RESULT- The test is positive for a syndesmosis (“high ankle”)

injury if pain is produced over the anterior or posterior tibiofibular
ligaments and the interosseous membrane. If pain is present
medially and the examiner feels the talus displace from the medial
malleolus, it may indicate a tear of the deltoid ligament
THOMPSON’S TEST
▶ PURPOSE- Evaluates integrity of achillis tendon

▶ DESCRIPTION- The patient lies prone or kneels on a chair with the feet over the
edge of the table or chair. While the patient is relaxed, the examiner squeezes the
calf muscles.

▶ RESULT- The absence of plantar flexion when the muscle is squeezed indicates a
positive test and a ruptured Achilles tendon (third-degree strain)
TINEL’S SIGN
▶ PURPOSE- Identifies dysfunction of posterior tibial nerve

▶ DESCRIPTION- The anterior tibial branch of the

deep peroneal nerve may be percussed in front
of the ankle. The posterior tibial nerve may be
percussed as it passes behind the medial
malleolus

▶ RESULT- In both cases, tingling or

paresthesia felt distally is a positive sign.
MORTON’S TEST
▶ PURPOSE- Identifies stress fracture or neuroma in forefoot

▶ DESCRIPTION- The patient lies supine. The examiner grasps the foot around the
metatarsal heads and squeezes the heads together.

▶ RESULT- Pain is a positive sign for stress fracture or

neuroma.
CERVICAL SPINE
VERTEBRAL ARTERY TEST
▶ PURPOSE- Assesses the integrity of vertebro-basilar vascular system

▶ DESCRIPTION- With the patient supine, the examiner passively takes the patient’s
head and neck into extension and side flexion. After this movement is achieved, the
examiner rotates the patient’s neck to the same side and holds it for approximately 30
seconds.

▶ RESULT- A positive test provokes referring

symptoms if the opposite artery is affected
HAUTANT’S TEST
▶ PURPOSE- Differentiate dizziness or vertigo caused by articular problems from that
caused by vascular problems

▶ DESCRIPTION- The patient sits and forward flexes both arms to 90°.The eyes are
then closed. The examiner watches for any loss of arm position. If the arms move,
the cause is nonvascular.

▶ The patient is then asked to rotate, or extend and rotate, the neck; this position is
held while the eyes are again closed. If wavering of the arms occurs, the dysfunction
is caused by vascular impairment to the brain. Each position should be held for 10 to
30 seconds
TRANSVERSE LIGAMENT STRESS
TEST
▶ PURPOSE- To test integrity of transverse ligament

▶ DESCRIPTION- The patient lies supine with head supported on the table. Glide C1
anterior. Should be firm end feel. The position is held for 10 to 20 seconds to see
whether symptoms occur, indicating a positive test

▶ RESULT- Positive symptoms include soft end feel; muscle spasm; dizziness; nausea;
paresthesia of the lip, face, or limb; nystagmus; or a lump sensation in the throat.
ANTERIOR SHEAR TEST
▶ PURPOSE- Test the integrity of the supporting ligamentous and capsular tissues of
the cervical spine

▶ DESCRIPTION- The patient lies supine with the head in neutral, resting on the bed.
The examiner applies an anteriorly directed force through the posterior arch of C1 or
the spinous processes of C2 to T1 or bilaterally through the lamina of each vertebral
body. In each case, the normal end feel is tissue stretch with an abrupt stop

▶ RESULT- Positive signs, especially when the upper cervical spine is tested, include
nystagmus, pupil changes, dizziness, soft end feel, nausea, facial or lip paresthesia,
and a lump sensation in the throat
FORAMINAL COMPRESSION
(SPURLING’S TEST)
▶ PURPOSE- Identifies dysfunction (compression) of cervical nerve root

▶ DESCRIPTION- The patient bends or side flexes the head to the unaffected side first,
followed by the affected side. The examiner carefully presses straight down on the
head.

▶ RESULT- The dermatome distribution of the pain and altered sensation can give
some indication as to which nerve root is involved
MAXIMUM CERVICAL
COMPRESSION TEST
▶ PURPOSE- Identify compression of neural structures at intervertebral foramen or
facet joint dysfunction

▶ DESCRIPTION- The patient side flexes the head and then rotates it to the same side.
The test is repeated to the other side. A positive test is indicated if pain radiates into
the arm.
▶ If the head is taken into extension (as well as side flexion and rotation) and
compression is applied, the intervertebral foramina close maximally to the side of
movement and symptoms are accentuated. Pain on the
concave side indicates nerve root or facet joint
pathology, whereas pain on the convex side indicates
muscle strain
DISTRACTION TEST
▶ PURPOSE- Identify compression of neural structures at intervertebral foramen or
facet joint dysfunction

▶ DESCRIPTION- Patient sitting and distract the head passively

▶ RESULT- Positive finding is decrease in symptom in neck (facet condition) or

decrease in upper limb pain (neurological condition)
SHOULDER ABDUCTION TEST
▶ PURPOSE- To test for radicular symptoms, especially those involving the C4 or C5
nerve roots.

▶ DESCRIPTION- The patient is sitting or lying down, and the examiner passively or
the patient actively elevates the arm through abduction so that the hand or forearm
rests on top of the head

▶ RESULT- A decrease in or relief of symptoms indicates a

cervical extradural compression problem, such as a
herniated disc, epidural vein compression, or nerve
root compression, usually in the C4–C5 or C5–C6 area.
LHERMITTE SIGN
▶ PURPOSE- Identifies dysfunction of spinal cord and upper motor neuron lesion.

▶ DESCRIPTION- The patient is in the long leg sitting position. The examiner passively
flexes the patient’s head and one hip simultaneously with the leg kept straight

▶ RESULT- A positive test occurs if there is a sharp, electric shock-like pain down the
spine and into the upper or lower limbs; it indicates dural or meningeal irritation in the
spine or possible cervical myelopathy.
THORACIC SPINE
RIB SPRINGING
▶ PURPOSE- Evaluates rib mobility

▶ DESCRIPTION- The patient lies prone or on the side while the examiner’s hands are
placed around the posterolateral aspect of the rib cage. The examiner’s hands are
approximately 45° to the vertical axis of the patient’s body. The examination begins at
the top of the rib cage and extends inferiorly, springing the ribs by pushing in with the
hands on each side in turn and then quickly releasing.

▶ RESULT- Positive finding is pain, excessive

motion of rib or restriction
THORACIC SPRINGING
▶ PURPOSE- Evaluates Intervertebral joint mobility in thoracic spine

▶ DESCRIPTION- Patient prone. Apply posterior/anterior/springs to transverse

processes of thoracic vertebra.

▶ RESULT- Positive finding is pain, excessive motion of rib or restriction

SLUMP TEST
▶ PURPOSE- Identifies dysfunction of neurological structures supplying lower limb

▶ DESCRIPTION- The patient sits on the examining table and is asked to “slump” so
that the spine flexes and the shoulders sag forward while the examiner holds the chin
and head erect.
If no symptoms, are produced, the examiner flexes the patient’s neck and holds the
head down and shoulders slumped to see if symptoms are produced.
If no symptoms are produced, the examiner passively extends one of the patient’s
knees to see if symptoms are produced.
If no symptoms are produced, the examiner then passively dorsiflexes the foot of the
same leg to see if symptoms are produced.

▶ RESULT- Reproduction of the patient’s

symptoms, implicating impingement of
the dura and spinal cord or nerve roots
LUMBAR SPINE
LASEGUE’S TEST(SLR)
▶ PURPOSE- Identifies dysfunction of neurological structures supplying lower limb

▶ DESCRIPTION- With the patient in the supine position, the hip medially rotated and
adducted and the knee extended, the examiner flexes the hip until the patient
complains of pain or tightness in the back or back of the leg. The examiner then
slowly and carefully drops the leg back (extends it) slightly until the patient feels no
pain or tightness. The patient is then asked to flex the neck, or the examiner may
dorsiflex the patient’s foot.

▶ RESULT- Reproduction of pathological neurological symptoms when foot is

dorsiflexed
FEMORAL NERVE TRACTION TEST
▶ PURPOSE- Identify compression of femoral nerve

▶ DESCRIPTION- The patient lies on the unaffected side with the unaffected limb
flexed slightly at the hip and knee. The examiner grasps the patient’s affected or
painful limb and extends the knee while gently extending the hip approximately 15°.
The patient’s knee is then flexed on the affected side; this movement further
stretches the femoral nerve

▶ RESULT- Neurological pain radiates down the anterior thigh if the test is positive.
VALSALVA MANEUVER
▶ PURPOSE- Identify a space occupying lesion

▶ DESCRIPTION- The seated patient is asked to take a breath, hold it, and then bear
down as if evacuating the bowels.

▶ RESULT- If pain increases, it indicates increased intrathecal pressure.

BABINSKI TEST
▶ PURPOSE- Identifies UMN lesion

▶ DESCRIPTION- The examiner runs a pointed object along the plantar aspect of the
patient’s foot.

▶ RESULT- A positive Babinski test or reflex suggests an upper motor neuron lesion if
present on both sides and may be evident in lower motor neuron lesions if seen only
on one side. The reflex is demonstrated by extension
of the big toe and abduction (splaying) of the other
toes.
QUADRANT TEST
▶ PURPOSE- Identify compression of neural structures at the intervertebral foramen
and facet dysfunction

▶ DESCRIPTION- The patient stands with the examiner standing behind. The patient
extends the spine while the examiner controls the movement by holding the patient’s
shoulders. Overpressure is applied in extension while the patient side flexes and
rotates to the side of pain. The movement is continued until
the limit of range is reached or until symptoms are produced

▶ RESULT- The position causes maximum narrowing of the

intervertebral foramen and stress on the facet joint to the
side on which rotation occurs. The test is positive if
symptoms are produced
STORK STANDING TEST
▶ PURPOSE-Identifies spondylolisthesis

▶ DESCRIPTION- The patient stands on one leg and extends the spine while balancing
on the leg. The test is repeated with the patient standing on the opposite leg.

▶ RESULT- A positive test is indicated by pain in the back and

is associated with a pars interarticularis stress fracture
(spondylolisthesis). If the stress fracture is unilateral,
standing on the ipsilateral leg causes more pain.
MCKENZIE SIDE GLIDE TEST
▶ PURPOSE- Differentiates between scoliotic curvature versus neurological
dysfunction causing abnormal curvature of trunk

▶ DESCRIPTION- The patient stands with the examiner standing to one side. The
examiner grasps the patient’s pelvis with both hands and places a shoulder against
the patient’s lower thorax. Using the shoulder as a block, the
examiner pulls the pelvis toward the examiner’s body. The
position is held for 10 to 15 seconds, and then the test is
repeated on the opposite side.

▶ RESULT- A positive test is indicated by increased neurological

symptoms on the affected side. It
BICYCLE (VAN GELDEREN’S TEST)
▶ PURPOSE- Differentiates between intermittent claudication and spinal stenosis

▶ DESCRIPTION- The patient is seated on an exercise bicycle and is asked to pedal

against resistance. The patient starts pedaling while leaning backward to accentuate
the lumbar lordosis. If pain into the buttock and posterior thigh occurs, followed by
tingling in the affected lower extremity, the first part of the test is positive. The patient
is then asked to lean forward while continuing to pedal. If the pain subsides over a
short period of time, the second part of the test is positive; if the patient sits upright
again, the pain returns.
▶ A patient with intermittent claudication of the lower extremities typically experiences
an increase in symptoms with continued exercise, regardless of the position of the
spine.
SACROILIAC JOINT
GILLET’S TEST
▶ PURPOSE- Assess posterior movement of the ilium relative to sacrum

▶ DESCRIPTION- While the patient stands, the sitting examiner palpates the PSISs
with one thumb and the other thumb parallel with the first thumb on the sacrum. The
patient is then asked to stand on one leg while pulling the opposite knee up toward
the chest. This causes the innominate bone on the same side to rotate posteriorly.
The test is repeated with the other leg palpating the other PSIS. If the sacroiliac joint
on the side on which the knee is flexed (i.e., the ipsilateral side) moves minimally or
up, the joint is said to be hypomobile, or “blocked,”
indicating a positive test.
IPSILATERAL ANTERIOR ROTATION
TEST
▶ PURPOSE- Assess anterior movement of ilium relative to sacrum

▶ DESCRIPTION- The patient stands. The examiner sits behind the patient and
palpates one PSIS with one thumb and the sacrum on a parallel line with the other
thumb. The patient is asked to extend the ipsilateral leg. Normally, the PSIS should
move superiorly and laterally. The other side is tested for comparison.

▶ RESULT- This test determines the ability of the innominate on the test side to rotate
anteriorly while the sacrum rotates to the opposite side
GAENSLEN’S TEST
▶ PURPOSE- Identifies SIJ dysfunction

▶ DESCRIPTION- The patient lies on the side with the upper leg (test leg)
hyperextended at the hip. The patient holds the lower leg flexed against the chest.
The examiner stabilizes the pelvis while extending the hip of the uppermost leg.

▶ RESULT- Pain indicates a positive test.

LONG SITTING (SUPINE TO SIT) TEST
▶ PURPOSE- Identifies SI joint dysfunction that may be the cause of leg length
discrepancy

▶ DESCRIPTION- The patient lies supine with the legs straight. The examiner ensures
that the medial malleoli are level. The patient is asked to sit up, and the examiner
observes whether one leg moves up (proximally) farther than the other. If so, it is
believed that there is a functional leg length difference resulting from a pelvic
dysfunction caused by pelvic torsion or rotation
GOLDTHWAIT’S TEST
▶ PURPOSE-Differentiate between lumbar spine and SIJ dysfunction

▶ DESCRIPTION- The patient lies supine. The examiner places one hand under the
lumbar spine so that each finger is in an interspinous space (i.e., L5–S1, L4–L5,
L3–L4, and L2–L3 interspaces). The examiner uses the other hand to perform SLR.

▶ RESULT- If pain is elicited before movement occurs at the interspaces, the problem
is in the sacroiliac joint. Pain during interspace movement indicates a lumbar spine
dysfunction
TMJ
TMJ COMPRESSION
▶ PURPOSE- Evaluates for pain with compression of the retrodiscal tissues

▶ DESCRIPTION- Patient sitting or supine. Support/stabilize the head with one hand,
with other hand push mandible superior, causing a compressive load to TMJ

▶ RESULT- Positive finding is pain in TMJ