ORTHOPAEDIC EXAMINATION

This ORTHOPAEDIC EXAMINATION is not intended to be an exhaustive list of hundreds of tests, but rather to consider a few that interest me.

The goal of the physical exam in general is to detect abnormalities in the human body, and like the rest the orthpedic examination is a challenge to the clinician.

In the acute patient often a whole batch of orthopedic tests are positive leading to confusion in the mind of the inexperienced doctor. It is the recognition of a pattern of positive tests and signs that enables him to make the critical diagnosis.

No one sign or test, in isolation, is of absolute significance and must be read into the context of the whole patient. One swallow doesn't make a summer! A difficult to find Posterior Tibial pulse doesn't make for a claudication but, in the presence of leg pain, a negative Lasegue and Braggard, and pain on walking or cycling it may be hugely significant. Whether the patient is a smoker, or has high cholesterol also comes into the equation ...

Many tests have a huge subjective bias and may be difficult to reproduce and interpret. A positive Yeoman test in the presence of a Kemp Test may well be negative in regard the Sacroiliac joint. An Adson test may appear to be positive, but a slight change in the position of the arm may change the picture completely. And so on ... critical thinking and experience are the most vital tools in the examination.

CONGENITAL, or DEVELOPMENTAL HIP DYSPLASIA.

Severe cases of Hip Dysplasia where the hip dislocates or subluxates readily are usually detected at birth, using the tests and signs of Ortholani, Galeazzi en Barlow.

Mild cases are however often only detected once the patient begins to complain of pain in the groin and upper thigh.

The grossly hypermobile (possibly clicking) hip in the child and adult should always be assessed for DDH. Otherwise it almost always progresses to severe hip arthritis.

It takes the chiropractor no more than 30 seconds to screen the hip joint for abnormalities. Detecting DDH and FAIS long before they present with pain will certainly make an enormous contribution to preventing future disability and total hip replacement.

HIP DYSPLASIA Ortholani Galeazzi and Barlow signs...

DEVELOPMENTAL HIP DYSPLASIA CaseFile ...

Shoulder Abduction Relief (SAR) sign

Faber test.

But you won't find this subluxation of the hip if you don't look for it. Read more about

Femero Acetabular Impingement Syndrome FAIS.

Hip arthritis.

The Faber test (Flexion-Abduction-External-Rotation) is also an important orthopaedic test for the Sacro-iliac Joint. Sacroiliac joint anatomy.

Cervical compression Test

SLUMP test

JULLS test

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