SPECIAL TESTS OFC
Equation used to determine the probability of a diagnosis after a positive test
(+) LR = Sn/(1-Sp)... >5 is good
AKA how many more times likely a positive test will be seen in those with the condition vs those without
What the Apprehension Relocation is used for
What is Ruling IN/out GHJ Instability
Sn 81 Sp 98
Limits axial rotation (especially CONTRALATERAL) and lateral flexion
What is alar ligament
For the apprehension-relocation test for instability this would cause the patient relief
AP pressure
(+) if there is an electric sensation with cervical flexion, and sometimes extension
Lhermitte's Sign
Test you should use to rule instability in and out.
What is Instability Cluster...Apprehension and Relocation (Sn 81; Sp 98)
Tests that make up Wainner's CPR for Cervical Radiculopathy
What are:
-Cervical Rotation < 60º
-Spurling's
-Distraction
-ULTT (Med Nerve A)
*RULE IN with 3/4 (+) tests (Sp 94) or 4/4 (Sp 99)
Specific structure being compressed using Spurling's test
Lateral foramen
Provides passive posterior stability of the GHJ
- Labrum
- Capsule
- CORACOHUMERAL LIG
The SLR is positive for radicular pain at ________º of hip flexion.
35-70º
CPR for Cervical Radiculopathy
What is Wainner's (4 test cluster)... RULE IN if 3/4 (Sp 94) or 4/4 (Sp 99) are (+)
- Cervical Rotation < 60
- Spurling's ((+) if LF reproduces sx's or LF + compression force in same direction)
- Distraction ((+) if traction force repro sx's)
- ULTT1(A)--Median N
Condition that you can rule IN with (+)'s on 4/5 of these and rule OUT if there's only one positive
- BIlateral sx's
- Leg Pain > Back pain
- Pain with walking/standing
- Pain relieved with sitting
- Age > 48
Cook's CPR for Lumbar Stenosis
CPG for Neck Pain with mobility deficits
- Cervical AROM
-Cervical Flexion-ROT test
-Upper cervical and thoracic mobility test
Painful arc is better used to rule out _______ than ________.
RC tear (Sn 98); Impingement (74)
Idk what the values for AC joint are
Main ligament for SC joint integrity
What is costoclavicular ligament
Used to best rule in humeral epicondylopathy
What is ultrasound (elastography) for LE and ME
If your patient tests positive on only one of these five tests/criteria, you can be pretty confident in ruling it out.
What are
- Gait Deviation
-Hoffman's
-Inverted Supinator
-Babinski
- >45 y/o
Pt is a 34 y/o F presenting with a sudden mod/severenheadache and neck pain; you notice that on the same side of her neck pain, their upper eyelid is drooping
You check their MHx and notice that they were diagnosed with Ehrlo's-Danlo's syndrome... What are you mainly concerned about and what tests might you do to confirm?
CAD (HA, neck pain, eye-lid drooping = Horner's syndrome)
- Wallenberg's (Cervical Extension/Rotation)
-VBI
-Body on Head
*IDK exactly which one but CAD has no clear link of sx's with head movement; VBI does
Best test to rule in fracture
Olecranon-Manubrium Percussion test (Sp 99; tuning fork Sp 80)
*Percussion and olecranon (alphabet P and O next to each other); Auscultation at manubrium (2 a's in both words)
Best test for ruling out SC joint sprain/dislocation? Best for ruling it in?
Out: Palpation (Tenderness); In: (Prominence or CT)
Condition in which the Can Tests are better used to rule it in
Condition in which the Can Tests are better used to rule it out
RULE IN: Impingement (Empty Sp 87, Full Sp 75).. vs Supraspin Tear (Empty Sp 50, Full Sp 57)
RULE OUT: Supraspinatus Tear (Empty Sp 89, Full 86)... vs Impingement (Empty 50, Full 45)
*also only thing Full Can is better at is ruling in supraspin, and not by much
Special tests included in the Lumbar CPG
- Centralization
- SLR
- Slump
- Prone Instability
- Aberrant motion
Positive if finger flexes or elbow extends
What is Inverted Supinator Sign (myelopathy special test; Sn 61 and Sp 78)
The best way to test for adhesive capsulitis
Palpate coracoid, AC, and subacromial region for pain... POSITIVE if there is a 3 point increase at coracoid vs the others
- Better for ruling out (Sn 96) but not bad to rule in (Sp 89)
To check for scapular dyskinesia you should do concentric and eccentric __________ and __________ 5x. What does winging during each of those motions indicate?
ABDUCTION: Upper/Lower Trap weakness
FLEXION: Serratus weakness