Knowledge base

Clinical tests

What you are examining, how to perform the test, when it is positive and what it is diagnostically worth.

Shoulder

• Neer impingement testSubacromial impingement of the supraspinatus tendon and the bursa.
• Hawkins-Kennedy testSubacromial impingement, in particular of the supraspinatus tendon under the coracoacromial ligament.
• Empty can testStrength and pain of the supraspinatus, tested with the thumb pointing down.
• Lift-off testFunction of the subscapularis.
• Shoulder apprehension testAnterior instability of the glenohumeral joint.
• Cross-body adduction testDisorder of the acromioclavicular joint.
• Bear hug testTear of the upper portion of subscapularis.
• Drop signTear of infraspinatus and teres minor.
• External rotation lag signTear of supraspinatus and infraspinatus.
• Full can testStrength and pain of the supraspinatus, tested with the thumb pointing up, with less load on the biceps…
• Hyperabduction testLaxity of the inferior part of the glenohumeral capsule.
• Piano key signVertical instability of the acromioclavicular joint after a dislocation.

Elbow

• Cozen testLateral epicondylitis (tennis elbow).
• Elbow valgus stress testIntegrity of the ulnar collateral ligament.
• Elbow varus stress testIntegrity of the radial collateral ligament.
• Moving valgus stress testChronic overload of the ulnar collateral ligament in throwing athletes.

Wrist and hand

• Phalen testCarpal tunnel syndrome.
• Finkelstein testDe Quervain stenosing tenosynovitis.
• Watson test (scaphoid shift)Scapholunate instability.
• TFCC compression testInjury of the triangular fibrocartilage complex.
• Anatomical snuffbox palpationScaphoid fracture after a fall on the outstretched hand.

Spine

• Straight leg raiseRadicular irritation of the lumbosacral roots.
• Spurling testCervical radiculopathy.
• Slump testNeurodynamic involvement of the lumbosacral nervous system.
• Posteroanterior pressureAt which spinal level the complaint sits, and how mobile that segment is.
• Prone instability testWhether a painful lumbar segment benefits from active stabilisation.
• Femoral nerve stretch testIrritation of the L2, L3 and L4 nerve roots via the femoral nerve.
• Wainner test clusterCervical radiculopathy.
• Romberg testWhether balance depends on vision, pointing to a disturbance of proprioception or the dorsal columns.

Pelvis

• Thigh thrustProvocation of the SI joint.
• Laslett's clusterThe SI joint as the source of the complaints.
• Active straight leg raiseLoad transfer between trunk and leg through the pelvis, in pelvic girdle pain.
• Van der Wurff test clusterWhether the sacroiliac joint is the source of the pain.

Hip

• FABER testDistinguishing between hip and SI problems.
• FADIR testFemoroacetabular impingement and labral injury.
• Trendelenburg testFunction of the hip abductors during single leg stance.
• Thomas testShortening of the hip flexors.
• Adductor squeeze testAdductor-related groin pain.
• Single adductor testDistinguishing left from right adductors in groin pain.

Knee

• Lachman testRupture of the anterior cruciate ligament, assessed at around 20 to 30 degrees of knee flexion.
• Anterior drawer testRupture of the anterior cruciate ligament, assessed at 90 degrees of knee flexion.
• McMurray testA tear in the medial or the lateral meniscus.
• Valgus and varus stress testInjury of the collateral ligaments.
• Posterior drawer testIntegrity of the posterior cruciate ligament.
• Posterior sag signPosterior cruciate injury, visible without applying force.
• Pivot shift testRotatory instability of the knee after an anterior cruciate rupture.
• Fluctuation test for effusionFluid in the knee joint and how much of it there is.
• Ottawa knee rulesWhether a radiograph is needed after a knee injury.
• Joint line tendernessMeniscal injury and its location.
• Noble compression testIliotibial band friction syndrome.

Ankle and foot

• Anterior drawer test of the ankleInjury of the anterior talofibular ligament.
• Thompson testComplete rupture of the Achilles tendon.
• Ottawa ankle rulesDecision rule on whether a radiograph is needed after an ankle injury.
• Talar tilt testIntegrity of the calcaneofibular ligament, and with greater tilt also of the anterior talofibular ligament.
• External rotation stress testInjury of the distal tibiofibular syndesmosis.
• Calf squeeze testInjury of the syndesmosis and of the interosseous membrane above it.
• Fibular translation testInstability of the syndesmosis in the anteroposterior direction.
• Ankle fluctuation testFluid in the talocrural joint.