By Paul Hattam MSc MCSP FSOM, Alison Smeatham MSc MCSP FSOM
The proliferation of exact assessments utilized in musculoskeletal exam has left the clinician with an unlimited array of actual exams at their disposal. Special exams in Musculoskeletal Examination is a convenient one-stop advisor with over a hundred and fifty peripheral exams. The medical context and proof base is punctiliously explored and the addition of medical suggestions and specialist opinion will permit the clinician to choose the main acceptable exams and interpret the implications meaningfully.
- Step-by-step description for every test
- Clear photographic illustrations
- 'At a look' presentation of the history evidence
- Detailed medical context
- Comprehensive referencing of orthopaedic certain tests
- Clinical tips
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Additional resources for Special tests in musculoskeletal examination : an evidence-based guide for clinicians
Empty/full can tests Aka Supraspinatus strength test Jobe’s test Scaption test Purpose To detect the presence of supraspinatus tendinopathy, a partial/ complete tear or neurogenic weakness of supraspinatus. Technique Patient position Standing or sitting on the edge of a treatment couch. Clinician position Standing on the affected side facing the patient. Action The shoulder is passively elevated to 90° in the scapular plane and taken into full internal rotation with the forearm in pronation so that the thumb is pointing to the floor (empty can test, Fig.
Positive test An inability to maintain the lifted-off position signifies a complete tear of the subscapularis tendon. Tendon tests 31 Fig. 6 ● Starting position of the lift-off sign. 05). The test performed with the hand in the mid-lumbar spine produced one third more EMG activity than with the hand over the sacrum. When resistance was added to the standard test (see Gerber push-off test below), there was an increase in the activity of all muscles, though only a small increase in the activity of the pectoralis major muscle (which was significantly more active during resisted internal rotation with the arm at the front of the body) (Greis et al 1996).
Patients with functional instability report catching and locking of the shoulder during movement and feel unable to ‘trust’ their shoulder, particularly when loading the arm in elevated positions. It is thought that these symptoms result from the partially attached labral fragment becoming temporarily interposed between the articulating surfaces of the glenoid and humeral head, thereby Labral tests 49 giving the transient but functionally impairing symptoms (Pappas et al 1983). The crank test combines axial loading with rotation movements and is broadly analogous to McMurray’s test at the knee.
Special tests in musculoskeletal examination : an evidence-based guide for clinicians by Paul Hattam MSc MCSP FSOM, Alison Smeatham MSc MCSP FSOM