Ortho Lab Test 1

Positive Findings: pain during passive &/or resisted ROM

• Indications: pain on resisted = strain
• Pain on passive = sprain

Positive Findings: unequal pulses, difference in systolic of 10+, Bruit

Indications: subclavian artery stenosis OR Carotid artery stenosis

Positive Findings: decrease or relief of Symptoms

Indications: disc &/or nerve root adhesion around C4/C5 or C5/C6

Positive Finding: Radicular Pain

Indication: Radiculopathy

Patient presents with their arm raised above their head because it alleviates their symptoms

Positive Findings: Radicular pain on the side that is flexed

Indications: Radicular pain = Radiculopathy

Reverse Spurling's: pain felt on opposite side of flexion = muscle spasm

Positive Finding: Radicular or Localized pain

• Indications: Radicular pain = disc, adhesions, stenosis
• Localized pain = muscular spasm, tightness, ligamentous injury

Positive Findings: exacerbation or relief of pain

• Indications: Exacerbation = Sprain/Strain
• Relief = IVF encroachment, facetal imbrication

Positive Findings: Radicular Pain, non-radicular pain

• Indications: Radicular pain = radiculopathy
• Non-Radicular pain = Same side is joint pathology
• Opposite side is Strain/Sprain

Positive Findings: severe spinal or extraspinal pain

Indications: Possible space occupying lesion {disc, stenosis, tumor}

Positive Findings: acute localized pain or radicular pain

• Indications: Localized = fracture of involved segment
• Radicular = possible disc lesion

Positive Test: acute local vertebral pain

Indications: cervical &/or upper thoracic vertebral Fracture

Severe cervical or cranial pathology

Positive Findings: difference of an inch or more, dominant upper extremity is smaller than the non-dominant side

Indications: Hypertrophy, edema, or atrophy

Positive Findings: Reproduction of symptoms & decrease pulse strength

Indications: Pect minor syndrome, or compression by a deformed coracoid process [Hyperabduction Syndrome]

Positive Findings: reproduction of symptoms & decrease pulse strength

Indications: scalenus anticus syndrome, cervical rib compression

a.k.a Costoclavicular test or military Brace Test

Positive Findings: reproduction of symptoms & decrease pulse strength

Indications: Costoclavicular sydrome, compression by elongated C7 TP's, cervical rib

Positive Findings: pain or paresthesias

Indications: compression or neuroma of 1+ nerve trunks

a.k.a elevated arm stress test {EAST}; Hands-up Test

Positive Findings: ischemic pain, profound weakness, paresthesias

Indications: TOS

Positive Findings: pain &/or discrepancy of an inch

Indications: GH dysfunction or tight muscles

Positive Findings: scapula moves prior to 70/80 degrees

Indications: GH joint restriction

Positive Findings: Humeral head doesn't depress [should 80-120]

Indications: GH joint glide restriction

Positive Findings: pain in the bicipital groove, especially w/palm up

Indications: Bicipital Tendinitis or Strain

a.k.a Empty Can Test

Positive Findings: pain w/ or w/o weakness

Indications: tear or teninitis of supraspinatus

a.k.a Codman's

Positive Findings: inability to hold arm up, arm gives away w/pressure, comed down in jerky mov't when lowered

Indications: complete tear of cuff= can't hold up; partial tear of cuff w/other two findings

Positive Findings: inability to lift hand away from back or inability to resist the load

Indications: Subscapularis strain or tendinitis

Positive Findings: deep shoulder pain in thumb down position is relieved w/palm up position

Indications: SLAP lesion or superior labral lesion

Positive Findings: weakness or scapular winging [btw 5-10]

Indications: weakness of scapular stabilizers; neuropathy [long thoracic nerve]

Positive Findings: excessive translation in the fossa

Indications: {1} translation of up to 50% {2} head pushed beyond rim 50%+ but reduces spontaneously {3} head remains dislocated after translation

a.k.a Sulcus Sign

Positive Findings: visible or palpable sulcus

Indications: inferior or multidirectional instability = +1 sulcus less than 1cm, +2 sulcus btw 1/2 cm, +3 sulcus greater than 2 cm

Positive Findings: apprehension, pain &/or mm splinting

Indications: recurrent anterior dislocation

Positive Findings: apprehension, pain &/or mm splinting

Indications: recurrent posterior dislocation or posterior instability

Positive Findings: pain in the anterior shoulder

Indications: impingement syndrome

Positive Findings: pain in anterior aspect of the shoulder

Indications: subacrominal impingment syndrome {possibly supraspinatus}

Positive Findings: palpable tenderness

Indications: Subacromal Bursitis

Positive Findings: if tender spot disappears as the arm is abducted

Indications: subacromial bursitis

Positive Findings: pain over lateral epicondyle

Indications: lateral epicondylitis

Positive Findings: lateral epicondyle pain

Indications: lateral epicondylitis

a.k.a medial epicondylitis Test

Positive Findings: pain over medial epicondyle

Indications: medial epicondylitis

Positive Findings: gapping along either medial or lateral joint line

Indications: medial {ulnar} or lateral {radial} collateral sprain

Positive Findings: pain &/or paresthesieas that follow the distribution of the ulnar nerve

Indications: cubital tunnel syndrome

Positive Findings: pain &/or paresthesias down the distribution of the ulnar nerve

Indications: cubital tunnel syndrome or regeneration of the nerve

Positive Findings: patient touches pad to pad

Indications: lesion to the anterior interosseous nerve

Positive Findings: acute pain in anatomical snuff box

Indications: stensosing tenosynovitis of abductor pollicis longus &/or extensor pollicis brevis, de Quervain's disease

Positive Findings: reproduction of paresthesias in the median nerve distribution

Indications: carpal tunnel syndrome

a.k.a Prayer Test

Positive Findings: reproduction of paresthesias in median nerve distribution

Indications: carpal tunnel syndrome

Positive Findings: reproduction of pain &/or paresthesias in median nerve distribution

Indications: carpal tunnel syndrome

Positive Findings: pt flexes terminal phalanx of the thumb because of adductor pollicis paralysis

Indication: ulnar neuropathy

Positive Findings: reproduction pain &/or paresthesias in ulnar nerve distribution

Indication: ulnar tunnel syndrome

Positive Findings: laxity of the joint or excess motion

Indications: sprain of the collateral ligaments

Positive Findings: skin remains blanched/pallor or cyanotic for more than 10 sec

Indications: ulnar or radial artery insufficiency {brachial}

Positive Findings: inability to squeeze equally or pick up object with precision

Indications: lesion to a nerve root, peripheral nerve, muscular lesion, bony lesion

Positive Indications: less than 3cm or 1"

Indications: Ankylosing conditions, rib problems or lung pathology

Positive Findings: scoliosis or rib hump is reduced or is maintained on flexion

Indications: same w/flexion = structural scoliosis, reduction = functional scoliosis

Positive Findings: localized pain in the ribs

Indications: rib fracture

Positive Findings: acute localized pain or radicular pain

Indications: localized = fracture or involved segment, radicular = possible disc lesion

Positive Findings: pain on either concave or convex side

Indications: pain concave- neuritis; pain on convex = sprain or pleurisy

Positive finding: umbilicus migrates to intact side

Indications: LMNL for roots that innervate the opposite quadrant from which the umbilicus migrated T6-T12