Ortho Lab Tests

Positive: Decrease pain and/or tenderness

Indicates: Subacromial bursitis

Positive: Inability to touch the opposite shoulder and/or inability of the elbow to touch the chest

Indicates: Acute dislocation of the glenohumeral Joint

Positive: pt will have a noticeable look of apprehension or alarm on their face with possible pain

Indicates: Chronic anterior dislocation of the glenohumeral joint

Positive: pt will have a noticeable look of apprehension or alarm on their face with possible pain

Indicates: Chronic posterior dislocation of the glenohumeral joint

Positive: pt will not be able to lower the arm slowly or the arm drops suddenly

Indicates: Rotator cuff tear, usually supraspinatus

Positive: 1) Localized pain and/or tenderness at the bicipital groove. 2) Audible click or the biceps tendon subluxes or dislocates

Indicates: 1) Bicipital tendenitis 2) Instability of the biceps tendon possibly associated with a torn transverse humeral ligament.

Positive: Palpable and/or audible click

Indicates: Subluxation or dislocation of the biceps tendon (Rupture of the transverse ligament or tendon subluxation beneath subscapularis muscle belly)

Positive: Pain and/or tenderness in the bicipital groove

Indicates Bicipital tendinitis

Positive: Exacerbation of pain

Indicates Degenerative tendinitis of rotator cuff tendons usually supraspinatus.

Positive: Pain in the shoulder

Indicates: Overuse injury to the supraspinatus and possibly biceps tendon

• Flexion: 180
• Extension: 60
• Abduction: 180
• Adduction: 50
• External rotation: 90
• Internal Rotation: 70
• Scapular retraction
• Scapular protraction
• Scapular elevation

• Flexion: 150
• Extension: 0
• Supination: 80
• Pronation: 80

Positive: Excessive gapping and pain

Indicates: Medial collateral ligament instability

Positive: Excessive gapping and pain

Indicates: Lateral collateral ligament instability

Positive: Pain and/or tenderness at the site being tapped and paresthesia in the ulnar nerve distribution area ( fingers 4,5)

Indicates: Neuroma of the ulnar nerve

Positive: Pain over the lateral epicondyle

Indicates: Lateral epicondylitis (Tennis Elbow)

Positive: Pain over the lateral epicondyle

Indicates: Lateral epicondylitis ( Tennis Elbow)

Positive:Pain over the medial epicondyle

Indicates: Medial Epicondylitis

• Wrist Flexion: 80
• Wrist Extension: 70
• Wrist ulnar deviation: 30
• Wrist radial deviation: 20
• Finger abduction
• Finger adduction
• Thumb flexion
• Thumb extension
• Finger flexion
• finger extension
• Finger opposition

Positive: Reproduction of pain, tenderness and/or paresthesia in the median nerve distribution area ( Thumb, 2nd, 3rd, and lateral half or the 4th digit)

Indicates: Carpal Tunnel Syndrome

Positive: Reproduction of pain, tenderness and/or paresthesia in the median nerve distribution area ( Thumb, 2nd, 3rd, and lateral half or the 4th digit)

Indicates: Carpal Tunnel Syndrome

Positive: Reproduction of pain, tenderness and/or paresthesia in the median nerve distribution area ( Thumb, 2nd, 3rd, and lateral half or the 4th digit)

Indicates: Carpal Tunnel Syndrome

Positive: Pain distal to the radial styloid process

Indicates: Stenosing tenosynovitis of the adductor pollicis longus and extensor pollicis brevis tendons (DeQuervain's Disease)

Positive: 1) Flexion of the proximal interphalangeal joint cannot be achieved. 2) Flexion of the proximal interphalangeal joint is achieved.

Indicates: 1) Joint capsule contracture. 2) Tight intrinsic muscles

Positive: 1) Flexion of the distal interphalangeal joint cannot be achieved. 2) Flexion of the distal interphalangeal joint is achieved

Indicates: 1) Joint capsule contracture. 2) Tight retinacular ligament

Positive: A delay of more than 10 seconds in returning a reddish color to the hand

Indicates: Radial or ulnar artery insufficiency. The Artery being held is not the one being tested.

A negative Allen's Test must be obtained before using the radial artery in the neurovascular compression test

• Flexion: 60
• Extension: 75
• Lateral flexion: 45
• Left and right rotation: 80

Positive: 1) Exacerbation of localized cervical pain. 2) Exacerbation of cervical pain with a radicular component.

Indicates: 1) Foraminal encroachment or facet pathology without nerve root compression. 2) Foraminal encroachment with nerve root compression or facet pathology ( then evaluate the myotome, reflex and dermatome of the nerve root involved.)

Positive: 1) Diminished or absence of pain. 2) Increase of cervical pain

Indicates: 1) Foraminal encroachment (local pain diminishes), nerve root compression (Radicular pain diminishes). 2) Muscular strain, ligamentous sprain, myospasm, facet capsulitis

Positive: 1) local pain. 2) Radiating pain

Indicates: 1) Possible fractured vertebrae, ligamentous involvement (spinous pain), muscular involvement ( muscular pain). 2) Possible disc pathology

Positive: 1) Localized pain on the side being tested. 2) Radicular pain on either side.

Indicates: 1) Localized Pain- Dural sleeve adhesions, and muscular adhesions/contracture, or spasm, or ligamentous injury. 2) Radicular Pain- On the side being tested neurovascular bundle compression, dural sleeve adhesions, or thoracic outlet syndrome. On the opposite side being tested foraminal encroachment with nerve root compression.

Positive: localized or radiating pain from site of lesion

Indicates: Space occupying lesion

Positive: Difficulty with swallowing

Indicates: Space occuopying lesion at anterior portion of the cervical spine. Possibly esophageal or pharyngeal injury, anterior disc defect, muscle spasm or osteophytes

Positive: Generalized pain in the cervical region, which may extend down to the level of T2

Indicates: Non-specific test for structural integrity of the cervical region

Positive: Inability to fully extend the leg and/or pain (usually in the neck region)

Indicates: Meningeal irritation/meningitis

Positive: 1) Pain during passive ROM. 2) Pain during resisted ROM.

Indicates: 1) Ligamentous sprain (Passive ROM stresses ligaments). 2) Muscle/tendon strain (Active ROM stresses muscles and tendons

• Disc level: C4
• Muscle tests: Shoulder abduction- deltoid (axillary)
• Forearm flexion- biceps (musculocutaneous)
• Reflex: Biceps

• Disc Level: C5
• Muscle tests: Wrist extension- extensor carpi radialia longus and brevis, and extensor carpi ulnaris (radial)
• Reflex: Brachioradialis

• Disc level: C6
• Muscle tests: Elbow extension- Triceps ( radial)
• Wrist flexion- flexor carpi radialis (Median), Flexor carpi ulnaris (ulnar). Finger extension- extensor digitorum communis, extensor indicis profundus, extensor digiti minimi (Radial)
• Reflex: Triceps

• Disc level: C7
• Muscle test: Finger flexion- flexor digitorum superficialis, flexor digitorum profundus, lumbricals (median and ulnar)
• Reflex: none

• Disc level: T1
• Muscle tests: Finger abduction- dorsal interossei (ulnar). Finger adduction- palmar interossei (ulnar)
• Reflex: None

• Flexion: 25
• Extension: 30
• Lateral flexion: 25
• Rotation: 30

Positive: lack of counter-pressure on the healthy side

Indicates: Lack of organic basis for paralysis (Malingering/hysteria). With organic hemiplegia, the pt will still exert downward pressure when attempting to raise paralyzed leg.

Positive: Radiating pain and/or dull posterior thigh pain.

Indicates: Sciatic radiculopathy or tight hamstrings. Positive between 35-70 degrees = possible discogenic sciatic radiculopathy

Positive: Localized pain, low back or radiating pain down the leg

Indicates: lumbosacral or sacroiliac pathology. Pain occuring after the lumbar spinouses move = possible lumbosacral problem. Pain occuring before the lumbars move = possible sacroiliac problem

Positive: Radiating pain in the posterior thigh

Indicates: Sciatic radiculopathy

Positive: Pain in the posterior thigh with sudden knee flexion

Indicates: Sciatic radiculopathy

Positive: Pain in the lumbar region or radiculopathy

Indicates: Sciatic nerve root compression, helps rule out tight hamstrings

Positive: Reproduction of sciatic pain before 60 degrees

Indicates: Sciatica

Positive: Inability to perform test and/or low back pain

Indicates: Weak abdominal muscles or space occupying lesion

Positive: Reproduction of radicular pain or inability to perform correctly due to tripod sign.

Indicates: Sciatic radiculopathy

Positive: Positive with a variety of low back pathologies. Hamstring tension on the pelvis may trigger the response

• Positive: The inability to bend at the waist more than 45 degrees because of either/or
• 1) radiating pain along the sciatic nerve, either unilateral or bilateral. 2) low back pain (lumbar or pelvic regions)

Indicates: 1) Sciatic neuralgia or radiculopathy, possibly due to lumbar disc pathology. 2) anterior (rotational) displacement of the ilium relative to the sacrum.

Positive: Radiating pain down the leg causing flexion of the pt's knee or knees.

Indicates: Gluteal, lumbosacral or sacroiliac pathologies

Positive: Inability to perform test

Indicates: L4-L5 disc problem (L5 nerve root)

Positive: Inability to perform test

Indicates: L5-S1 disc problem (S1 nerve root)

Positive: 1) Inability to raise the thigh. 2) Pain in the anterior thigh. 3) Pain in the lumbar region.

Indicates: 1) Iliopsoas. 2) Inflammation of lumbar nerve roots. 3) Lumbar nerve root adhesions

• Disc level: L3
• Muscle test: Foot dorsiflexion and inversion- tibialis anterior (deep peroneal nerve)
• Reflex: Patella Tendon

• Disc Level: L4
• Muscle Test: Foot dorsiflexion- name two muscles (multi nerve). Big toe dorsiflexion- extensor hallucis longus (deep peroneal nerve). Toes 2,3,4 dorsiflexion- extensor digitorum longus and brevis (deep peroneal nerve). Hip and pelvis abduction- gluteus medius and minimus (superior gluteal nerve)
• Reflex: none

• Disc Level: L5
• Muscle Tests: Foot Plantarflexion- Gastrocnemius and Soleus (Tibial). Foot plantar flexion and eversion- peroneus longus and brevis (Superficial peroneal). Hip extension- gluteus maximus (inferior gluteal)
• Reflex: Achilles

Positive: 1) Pain in the hip region. 2) Pain in the buttock/pelvic region.

Indicates: 1) Hip joint pathology. 2) Sacroiliac joint lesion

Positive: Affected thigh remains in abduction (normal biomechanics, the thigh/hip will adduct.)

Indicates: Contraction of the iliotibial band or tensor fascia lata, (usually secondary to synovitis of the hip, secondary to trauma of the gluteus medius and maximus)

Positive: Pain in either sacroiliac joint

Indicates: Sacroiliac joint lesion

Positive: Pain in the buttock and/or pain in the lumbar region

Indicates: Sacroiliac Joint lesion, or lumbar pathology

Positive: Pain deep in the SI joint

Indicates: Strain/sprain of the anterior sacroiliac ligaments

Positive: hip on side being tested will flex causing the buttock to raise off the table

Indicates: Rectus femoris or hip flexor contracture

Positive: high iliac crest on the supported side and low crest on the side of elevation

Indicates: Weak gluteus medius muscles on the supported side

• Flexion: 120
• Extension: 30
• Abduction: 45
• Adduction: 45
• Internal rotation: 45
• External rotation: 45
• Flexion and adduction
• Flexion, Abduction and External rotation

Positive: Different Measurements

Indicates: True = bony abnormality above or below level of trochanter difference (anatomical short leg). Apparent = pelvic obliquity (Tilted pelvis)

Positive: Difference in height and anteriority of the knees

Indicates: 1) If 1 knee is lower = ipsilateral congenital hip dislocation or tibial discrepancy (anatomical short leg). 2) If 1 knee is anterior = ipsilateral congenital hip dislocation or femoral discrepancy (contralateral anatomical short leg)

Positive: Lumbar spine maintains lordosis (should flatten) and opposite hip does not straighten

Indicates: Contracture of the hip flexors (iliosoas)

Positive: Localized pain in the long bone or in the hip joint

Indicates: Possible fracture of long bones, or hip joint pathology

Positive: Pain in the hip region

Indicates: Hip joint pathology

Positive: 1) Pain in the hip region. 2) Pain in the sacroiliac joint

Indicates: 1) Hip joint pathology. 2) Mechanical problem of the sacroiliac joint

Positive: Pain on the affected SI joint stressed into extension

Indicates: General sacroiliac joint lesion, anterior sacroiliac ligament sprain, or inflammation of the SI joint

Positive: Pain on the side of extension

Indicates: General sacroiliac joint lesion, anterior sacroiliac ligament sprain, or inflammation of the SI joint

• Flexion: 135
• Extension: 0
• Internal rotation
• External rotation

Positive: Clicking sound or pain by knee joint

Indicates: Tear of medial meniscus if positive on external rotation. Tear of lateral meniscus if positive on internal rotation. The higher the leg is raised when positive is elicited, the more posterior the meniscal injury.

Positive: Gapping and/or elicited pain above/at/or below joint line

Indicates: Torn medial collateral ligament

Positive: Gapping and/or elicited pain above/at/or below joint line

Indicates: Torn Lateral collateral ligament

Positive: Knee does not go into full extension (slight flexion remains)

Indicates: Diffuse swelling of the knee, accumulation of fluid, due to possible torn meniscuc

Positive: 1) Gapping > 6mm (tibia moves posterior) when the leg is pushed. 2) Gapping > 6mm (tibia moves anterior) when the leg is pulled.

Indicates: 1) Torn posterior cruciate ligament. 2) Torn anterior cruciate ligament.

Positive: Gapping with the tibia moving away from the femur

Indicates: Anterior cruciate ligament or posterior oblique ligament instability

Positive: Apprehension, distress of facial expression, contraction of quadriceps to bring patella back in line

Indicates: Chronic patella dislocation or pre-disposition to dislocation.

Positive: Retropatellar pain and the patient is unable to hold the quadriceps contraction.

Indicates: Degenerative changes of the patellar facets and/or within the trochlear groove (chondromalacia patella)

Positive: A floating sensation of the patella is a positive finding

Indicates: A large amount of swelling in the knee

Positive: Patient points to side of pain

Indicates: Pain on medial side is medial meniscus tear. Pain on the lateral side indicates lateral meniscus tear.

Positive: Patient will point to the side of pain

Indicates: Pain on the medial side indicates medial collateral ligament tear. Pain on the lateral side indicates lateral collateral ligament tear.

• Ankle Dorsiflexion: 20
• Ankle Plantarflexion: 50
• Subtalar Inversion: 5
• Subtalar Eversion: 5
• 1st MTP Joint Flexion
• 1st MTP Joint Extension

Positive: Translation with the talus moving away from or toward the tibia

Indicates: 1) With tibia pushed/foot pulled; a tear/instability of the anterior talofibular ligament. 2) with tibia pulled/foot pushed; a tear/instability of posterior talofibular ligament.

Positive: 1) the foot cannot dorsiflex with knee extended, but is able to with knee flexed. 2) the foot cannot dorsiflex in either knee position

Indicates: 1) contracture of the gastrocnemius muscle. 2) contracture of the soleus muscle.

Positive: 1) Absence of medial longitudinal arch in both positions. 2) Presence of medial longitudinal arch while seated with a loss of medial longitudinal arch while standing.

Indicates: 1) Rigid flat feet. 2) Supple Flat feet.

Positive: Deep pain in the calf

Indicates: Deep vein thrombophlebitis.

Positive: Absence of foot plantarflexion

Indicates: Achilles tendon rupture

Positive: Sharp pain in the forefoot

Indicates: Metatarsalgia or neuroma (usually at the 3rd and 4th metatarsal interspace)

• 1) Sternoclavicular articulation
• 2) Clavicle
• 3) Coracoid process
• 4) Acromioclavicular articulation
• 5) Acromion
• 6) Greater tuberosity
• 7) Bicipital groove
• 8) Lesser tuberosity
• 9) Spine of the scapula
• 10) Body of scapula
• 11) Scapulothoracic articulation

• 1) Rotator cuff muscles
• - Supraspinatus
• - Infraspinatus
• - Teres minor
• - Subscapularis
• 2) Subacromial bursa
• 3) Subdeltoid bursa
• 4) Axillary borders
• - Pectoralis major
• - Serratus anterior
• - Axillary lymph nodes
• - Latissimus dorsi
• - Bicipital tendon
• 5) Prominent muscles or region
• - Sternocleidomastoid
• - Biceps
• - Deltoid (ant, middle,post)
• - Trapezius
• - Rhomboid (major,minor)

• 1) Medial epicondyle
• 2) Medial supracondylar line of the humerus
• 3) Groove of the ulnar nerve
• 4) Trochlea
• 5) Olecranon
• 6) Olecranon fossa
• 7) Lateral epicondyle
• 8) Lateral supracondylar line of the humerus
• 9) Radial head

• 1) Ulnar nerve
• 2) Wrist flexors
• - Pronator teres
• - Flexor carpi radialis
• - Palmaris Longus
• - Flexor carpi ulnaris
• 3) Medial collateral ligament
• 4) Supracondylar lymph nodes
• 5) Brachial Artery
• 6) Triceps
• 7) Lateral collateral ligament
• 8) Biceps
• 9) Olecranon bursa
• 10) Elbow Flexors
• - Brachioradialis
• - Extensor carpi radialis longus
• - Extensor carpi radialis brevis

• 1) Radial styloid process
• 2) Scaphoid
• 3) Lunate
• 4) Lister's tubercle
• 5) Triqutrium
• 6 ) Pisiform
• 7) Trapezium
• 8) Trapezoid
• 9) Capitate
• 10) Hook of hamate
• 11) Metacarpals
• 12) Phalanges

• 1) Ulnar artery
• 2) Radial artery
• 3) Palmaris longus tendon
• 4) Carpal tunnel region
• 5) Thenar eminence
• 6) Hypothenar eminence
• 7) palmar aponeurosis
• 8) Tissues surrounding PIP joints
• 9) Tissues surrounding DIP joints
• 10) Distal tufts of fingers

• Anterior
• 1) Hyoid
• 2) Thyroid cartilage
• 3) First cricoid ring
• 4) Mandible
• Posterior
• 1) Occiput
• 2) Inion
• 3) Superior nuchal line
• 4) Mastoid process
• 5) Spinous processes of cervical vertebrae
• 6) Facet joints

• 1) Sternocleidomastoid
• 2) Anterior lymph node chain
• 3) Posterior lymph node chain
• 4) Thyroid gland
• 5) Carotid pulse
• 6) Supraclavicular fossa
• 7) Traps
• 8) Greater occipital nerves
• 9) Superior nuchal ligament

• 1) Lumbar spinous processes
• 2) Sacral tubercles
• 3) iliac crest
• 4) PSIS

• 1) Paraspinal muscles
• - Spinalis
• - Longissimus
• - Iliocostalis
• 2) Sciatic nerve
• 3) Gluteus maximus
• 4) Gluteus minimus
• 5) Hamstrings
• - Biceps femoris
• - Semitendinosus
• - Semimembranosus
• 6) Anterior abdominal muscles

• Anterior
• 1) ASIS
• 2) Iliac crest
• 3) Iliac tubercle
• 4) Greater trochanter
• Posterior
• 1) PSIS
• 2) Ischial tuberosity
• 3) Coccyx

• 1) Femoral Triangle borders
• - Sartorius
• - Adductor longus
• - Inguinal ligament
• 2) Quadriceps muscles
• - Vastus lateralis
• - Vastud medialis
• - Vastus intermedius
• - Rectus Femoris
• 3) Greater trochanteric bursa
• 4) Gluteus medius
• 5) Gluteus maximus
• 6) Sciatic nerve
• 7) Cluneal nervers
• 8) Hamstrings
• - Biceps femoris
• - Semitendinosus
• - Semimembranosus

• 1) Patella
• 2) Medial tibial plateau
• 3) Tibial tubercle
• 4) Medial femoral condyle
• 5) Lateral tibial plateau
• 6) Lateral femoral condyle
• 7) Fibula head

• 1) Quadriceps
• - Vastus Lateralis
• - Vastud medialis
• - Vastus intermedius
• - Rectus femoris
• 2) Infrapatellar tendon
• 3) Bursae
• - Prepatellar
• - Superficial infrapatellar
• 4) Medial meniscus
• 5) Lateral meniscus
• 6) Pes anserine area
• - Sartorius
• - Gracilis
• - Semitendinosus
• 7) Popliteal fossa
• 8) Lateral collateral ligament
• 9) Medial collateral ligament
• 10) Gastrocnemius

• 1) Calcaneus
• 2) Sustentaculum tali
• 3) Medial malleolus
• 4) Lateral malleolus
• 5) Talus
• 6) Navicular
• 7) Cuboid
• 8) 3 cuneiforms
• 9) 5 metatarsals
• 10) Metatarsophalangeal joints

• 1) Tibialis posterior tendon
• 2) Spring ligament
• 3) Tibialis anterior tendon
• 4) Deltoid ligament
• 5) Peroneus brevis
• 6) Achilles tendon
• 7) Plantar aponeurosis
• 8) Anterior talofibular ligament
• 9) Posterior tibial artery
• 10) Dorsal pedal artery