View Dr Michael Ellis conducting examination and physical tests for meniscal tears of the knee. This video (3:03 minutes) demonstrates four physical tests used in the diagnosis of a meniscal tear
Positive test result: when the patient feels pain and there is an audible or palpable ‘snap’, ‘click’ or ‘thud’ during extension movement. Starts at 0:07 Positive test result: when the patient experiences medial or lateral joint line pain. Starts at 1:08 Positive test result: when the patient experiences pain during the palpation. Pain along the medial joint line indicates medial meniscus damage, and along lateral joint line indicates lateral meniscus damage. Starts at 1:46 Apley grind test
Positive test result: when there is pain and/or clicking. Starts at 2:22 Knee injury: ACL tearThis video ( 2:20 minutes) demonstrates three physical tests used in the diagnosis of an ACL
tear.
Lachman test
Note: There can be a false-negative result if the patient’s hamstrings are not relaxed. Starts at 0:08 Anterior drawer test
Positive test result: increased anterior translation movement with a soft endpoint compared with the uninjured knee. Starts at 0:50 Pivot shift test
Positive test result: audible or palpable ‘clunk’, usually occurring at 30° flexion. Starts at 1:40 Ankle injury: sprain :lateral ligamentThis video (1:12 minutes) demonstrates two physical tests used in the diagnosis of an ankle sprain (lateral ligament).
Anterior drawer test
Positive test result: excessive anterior translation movement compared with the uninjured ankle. Starts at 0:08 Talar tilt test
Positive test result: increased inversion movement compared with the uninjured ankle. Starts at 0:39 Fracture: Ottawa rulesThis video (2:09 minutes) demonstrates the Ottawa Rules used to determine whether or not to refer a patient for X-ray series to diagnose fractures of
the ankle (and foot) and knee.
Ottawa Ankle RulesAn ankle X-ray series is only required if there is any pain in the malleolar zone and any of these findings:
A foot X-ray series is only required if there is any pain in the mid-foot zone and any of these findings:
Starts at 0:08 Ottawa Knee RulesA knee X-ray series is only required for patients with knee injury if any of these findings are present:
Starts at 1:17 Evidence-based and best practiceAll the instructions in the videos are evidence based. However, there is variability in the medical literature regarding instructions on how to do the physical tests in particular. After an extensive review of this variability, the physical test instructions included in the videos are regarded as best practice. ExaminerDr Michael Ellis, MBBS (SYD), MMed (Musculoskeletal), FRACGP Dip RACOG References
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