Special tests what are they good for

In this episode we discuss what special tests are good for and how they fit in the diagnostic process. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6994315/ ACL test cluster (LR+ 15, LR - 27) History of Trauma Pivoting during injury felt/heard a pop immediate swelling experiencing giving way Lachman (LR+ 10, LR- 0.2) Hip Labrum and FAl test Thomas test LR+ 11.1 Reproduction of patients pain with/without a click Hip OA cluster LR+ 3/5= 5.2, 4/5= 24.3 Pain with squatting Scour Pain with active hip flexion Passive IR <25 Pain with active hip extension Shoulder Subacromial pain syndrome cluster (LR+ 10) Hawkins-Kennedy impingement sign Painful arc sign •Infraspinatus muscle test Neer Impingement Empty Can Lumbar Radiculopathy Dermatomal pattern Subjective sensory loss Paresis Decreased ankle reflex unilateral + SLR and or cross SLR sign Pain with coughing, sneezing or straining More pain with sitting Myotomal weakness (+/-). Patellofemoral pain syndrome Cluster 1 (<40 years LR+ 8.7, LR- .39) Medial patellar tenderness Under 40 years of age Isolated knee pain Cluster 2 (40-58 years old LR+14.2, LR-45) Age 40-58 and isolated anterior or diffuse knee pain difficulty descending stairs medial patellar facet tenderness full passive knee extension Rotator cuff teat diagnostic cluster (LR+ 9.8;, LR- 0.53) Age 265 weakness in ER (infraspinatus test) night pain Shrug sign Stenosis LR+ 4/5=4.6, 5/5=infinite Bilateral symptoms Leg pain more than back Age >48 Pain with walking and standing Pain relief with sitting (+/-) Meniscus Cluster History of pivoting injury with foot planted Joint line tenderness McMurray test Thessaly test Knee OA Clinical cluster LR +13.6 LR - .38 Age 50-58 BMI >30 Varus/algus alignment Limited passive knee extension Palpable crepitus Knee OA diagnostic cluster (LR+ 13.6; LR- 0.38) Age 50-58 BMI ≥30 Varus/valgus alignment limited passive knee extension PCL cluster (LR+ 16, LR- 0.2) History of falling on a bent knee Posterior Drawer (LR+ 50, LR -. 11) Cluster for Carpal Tunnel syndrome LR+ 4/5= 4.6, 5/5=18.3, LR-4/5= .028, 5/5=.83 1. Shaking hands to relieve symptoms 2. Wrist ratio > 67 3. Symptom Severity Scale > 1.9 4. Diminished sensation in median sensory field 1 (thumb) 5. Age > 45 years old Test cluster for myelopathy (positive likelihood ratio 3/5 30, 4/5 infinite) Hoffman sign Brachioradials reflex Age >45 Gait deviation Babinski sign Cervical Radiculopathy (likelihood ratios 3/5 +6.01 -0.65, 4/5 +30.3 - 0.77) ULTT <60 rotation bilaterally Distraction Spurlings Cervical Traction Cluster (3/5 positive likelihood 4.81, 4/5 23.1) Abduction relief ULTTA Age >55 Distraction Periphrealization with mobility testing at C4-7