1, forward flexion and rotation test: (Fenz sign) first make the patient’s head and neck forward flexion, and then left and right rotation activities, if the cervical spine pain is positive, suggesting cervical spine osteoarthrosis, indicating that the cervical spine small joints have degenerative lesions.
2, intervertebral foramen extrusion test: (Spurling sign) the patient’s head turned to the affected side and slightly flexed, the examiner’s left hand palm placed on the top of the patient’s head, the right hand lightly tapping the back of the palm when the affected limb appears radioactive pain or numbness, that is positive. This indicates nerve root damage, which is seen in cervical spondylosis of the nerve root type.
3, cervical spinal nerve root tension test: (Eaten sign or Lasequard sign) patient sitting, the examiner pushed the patient’s head to the healthy side with one hand, the other hand holding the patient’s wrist and traction downward, if the numbness and pain of the affected limb is positive. This indicates neurogenic cervical spondylosis, brachial plexus injury or anterior oblique angle muscle syndrome.
4.Addsion sign：The patient sits, turns his head to the affected side, inhales deeply and then holds his breath, the examiner holds the patient’s jaw with one hand and feels the radial artery on the affected side with the other hand. This suggests vascular compression, commonly seen in anterior oblique muscle syndrome.
5, Thomas sign: patient lying supine, thighs straight, then the lumbar anterior convexity; flexion of the hip and knee joints on the healthy side, forcing the compensatory anterior convexity of the spine disappears, then the thighs on the replacement side are forced to lift and cannot touch the bed, that is positive. Commonly found in the lumbar spine, sacroiliac joint and hip joint lesions, or spasm of the internal retractor muscle.
6.Straight leg elevation test: (Lasegue sign) patient lying on his back, the examiner holds the affected heel with one hand, the other hand keeps the knee joint straight, elevate the affected limb until the patient has pain, and record the angle, the radioactive pain of sciatic nerve at 30~70 degrees is positive. bragard sign: in Lasegue (+), slowly lower the height of the affected limb, wait until the radioactive pain disappears After that, the ankle joint is passively flexed again, and if radioactive pain appears again, it is positive. A positive sign is the main diagnostic basis for lumbar disc herniation.
7.Arid test: The patient sits on the bedside with both lower legs hanging down, and the lower legs are raised separately to observe the height of the lower legs and the angle of knee flexion when pain and numbness appear, and the result is the same as lasegue.
8.Anti-Lasegue sign: patient lying prone, passive flexion of the knee joint (femoral nerve is strained) will be painful, suggesting possible high disc; flexion of the knee and hyperextension of the hip joint, pain increases suggesting high disc lesion.
9.Bowing test: (Neri test) Patients standing, do bowing action appears to be positive for radiating pain on the posterior side of the affected limb. It suggests sciatic nerve compression.
10.Flexion neck test: (Linder test) The patient lies on his back, the examiner presses his chest with one hand, places the other hand behind his pillow, flexes his neck, and if there is radioactive pain in the lumbar area and the posterior side of the affected limb, it is positive, suggesting sciatic nerve compression.
11.”4″ test: (Patrick sign or Fabere sign) The patient lies supine, the affected limb is flexed at the hip and knee, and abducted and externally rotated, the outer ankle is placed on the opposite thigh, the two legs are crossed in the shape of a “4”, the examiner fixes one hand on the The examiner fixes the pelvis with one hand and presses downward on the knee with the other hand. Suggest sacroiliac joint lesions such as strain, similar to rheumatoid arthritis, tuberculosis-dense osteitis, etc.
12, bedside test: (Gaenslen sign) patients lying supine, flexion of the healthy side of the hip, knee joint, let the patient hold. The affected thigh hangs off the edge of the bed. The examiner presses the healthy knee with one hand and presses the affected knee with the other hand, and the presence of sacroiliac joint pain is positive. It means that there is a lesion in the sacroiliac joint.
13.Hip extension test: Yeoman sign The patient is lying prone, the examiner presses the affected sacrum with one hand, holds the affected ankle with the other hand and lifts the affected knee upward after flexing 90 degrees, so that the hip joint is hyperextended, at this time the sacroiliac joint must be twisted, if pain appears, it is positive. Suggest that the sacroiliac joint has lesions.
14, wrist extensor tension test: Mills sign patient straighten the affected elbow joint, forearm rotation forward, the examiner will be the affected wrist joint flexion, if the patient humeral epicondyle pain that is positive. Suggest humeral epicondylitis.
15.Cozen test: i.e. forearm extensor muscle tension test. Flex the elbow joint, try to rotate the forearm forward, then extend the elbow, if the humeral epicondyle pain is positive. This suggests epicondylitis of the humerus.
16.The chair test: The patient extends the elbow, bends the shoulder forward 60°, lifts a chair with both hands, if lifting is difficult or accompanied by pain in the humeral epicondyle is positive. This suggests humeral epicondylitis.
17.THomsen test: The patient clenches the fist, extends the wrist joint dorsally and extends the elbow. When the patient extends the wrist joint dorsally, the examiner resists with force and flexes it, and the pain of the humeral epicondyle is positive. Suggest humeral epicondylitis.
18.Huter triangle：Under normal circumstances, when the elbow joint is straight, the medial and lateral epicondyles of the humerus and the ulnar eminence are in a straight line; when the elbow joint is flexed, the line between the three is in an isosceles triangle. The relationship between the three positions remains unchanged in the case of supracondylar humerus fracture, and changes in the case of elbow dislocation.
19.Finkel’s sign: Finkelsein sign or Finkel-stein sign The patient’s thumb is held in the palm, so that the wrist joint is passively ulnar deviated, and the pain at the radial tuberosity is positive, which is a sign of radial tuberosity stenosis tenosynovitis.
20.One-foot independent test: Trendelenburg test The patient’s back to the examiner, the healthy side of the hip flexion knee lift, stand with the affected limb, if the healthy side of the pelvis and hip fold down that is positive. It is mostly seen in gluteus medius and minimus paralysis, hip dislocation and old femoral neck fracture or developmental hip dislocation.
21.Telescope test: Dupuytren sign The patient lies on his back, the examiner holds the knee with one hand, fixes the pelvis with the other hand and pushes the femoral stem up and down, if a twitching or ringing is perceived, it is positive, suggesting congenital hip dislocation in children.
22, iliotibial bundle test: Ober sign patient lying on the healthy side, the healthy side of the hip flexion knee, the examiner fixed the pelvis with one hand, the affected side of the ankle with the other hand, flexion of the hip flexion knee up to 90 °, abduct the thigh and straighten the affected knee, the thigh can not fall naturally, and can be touched in the affected side of the thigh rope-like objects or the affected side of the active inward, the tip of the foot can not touch the bed, that is positive. It indicates spasm of the iliotibial bundle.
23, Ortolani sign: the child lies on his back, both hips are abducted, legs are separated, the affected knee joint cannot touch the bed; if it can, there is a sliding sound first (this is a temporary reset sign), that is positive. It suggests congenital hip dislocation in children.
24, Barlow test: Ortolani sign negative, does not indicate that the hip joint is stable, in order to further determine, use this test. The examiner fixes the pelvis with one hand at the pubic symphysis and sacral tip, and applies pressure to the posterior with the other hand to try to dislocate the hip joint. If the femoral head is felt to be dislocated to the posterior half, then the remaining fingers push the greater trochanter forward or increase the abduction angle to possibly reset the femoral head, suggesting pediatric hip instability.
25, Nelaton line: that is, the iliac sitting line. The patient is lying on his side and the line from the anterior superior iliac spine to the sciatic tuberosity is passing through the highest point of the greater trochanter. Otherwise, it is positive, suggesting hip dislocation or femoral neck fracture.
26.Shoemaker line ：That is, the line of the anterior superior iliac spine of the greater trochanter. The apex of the right and left greater trochanter is connected to the anterior superior iliac spine on the same side, and its extension line intersects with the abdominal midline. If the greater trochanter is displaced upward, the two lines intersect with the healthy side next to the midline. It indicates hip dislocation or femoral neck fracture.
27.Bryant triangle：That is, iliofemoral triangle. With the patient in supine position, draw a line from the anterior superior iliac spine vertically downward and the tip of the greater trochanter, and then draw a horizontal line from the side adjacent to the tip of the greater trochanter, the triangle formed by the three lines is the iliofemoral triangle. When the greater trochanter moves up, the bottom edge of the secondary triangle (horizontal line) is shorter than the healthy side, suggesting hip dislocation or femoral neck fracture.
28.Allis sign：also known as Galeazzi sign. The patient lies supine, flexes the hip and knee, and places the two feet parallel to the bed, and compares the height of the two knees. If the height is not equal, it is positive. It indicates posterior dislocation of the hip joint, femur or tibia shortening.
29.Dugas sign: If the elbow joint of the affected limb is flexed and the hand is placed on the contralateral shoulder joint, the elbow cannot be attached to the chest wall; or the elbow can be attached to the chest wall, but the hand cannot be placed on the contralateral shoulder is positive. This suggests shoulder dislocation.
30.Gerber Drawer test (Ganz Drawer test): the shoulder joint front instability drawer test. The upper extremity of the affected limb is abducted 90 degrees, relaxed on the lateral side of the examiner’s body, and mildly flexed in external rotation. The thumb of one hand is placed on the rostral process and the remaining four fingers are placed posteriorly to fix the scapula. The humeral head is pulled forward using the other hand. The patient is positive if abnormal activity, pain and fear are present, compared on both sides. Suggests anterior instability of the shoulder joint.
31.Straight ruler test: Hamilton sign Place a straight ruler on the lateral side of the upper arm with one end against the lateral epicondyle of the humerus, then the other end cannot be attached to the acromion. If the other end can be attached to the shoulder peak, it is positive. This indicates a dislocation of the shoulder joint.
32. Biceps long head tension test: Yergason test The patient flexes the elbow, rotates the forearm back, and the examiner gives resistance. When there is biceps long head tendinitis, there is pain in the inter-nodal groove area.
33.Hawkin test：The supraspinatus impingement test. The patient stands with the shoulder abducted at 90°, the examiner internally rotates the patient’s shoulder joint, and the pain is felt during the movement. This indicates an injury to the supraspinatus tendon.
34.Dawbarn sign：In acute subacromial bursitis, the upper arm of the affected limb is pressed against the front of the chest wall, and the pain can be felt under the anterior border of the shoulder peak.
35.Floating patella test：That is, floating patella test. The patient is supine, knees extended, quadriceps relaxed, the examiner places one hand on the proximal side of the patella and squeezes the fluid of the suprapatellar bursa into the joint cavity, the other hand shows the finger and middle finger to press down sharply, if the patella is felt to touch the femoral condyles, it is positive. Generally, a moderate amount of fluid (50 ml) or more will result in a positive floating patella test. It indicates fluid accumulation in the knee joint cavity.
36, patellar friction test: Soto-holl sign patient supine, knee extended, the examiner pressed the patella with one hand, so that it moves up and down on the femoral joint surface, if there is friction sound or pain is positive. It is seen in bin bone chondromalacia.
37, Mcmurray test : patient supine position, the examiner presses the affected knee with one hand, holds the ankle with the other hand, the knee is completely flexed heel against the hip, then the calf is extremely abducted and externally rotated or internally rotated, in maintaining this stress, gradually straighten, then straighten the process if you feel or hear a popping sound, or accompanied by pain that is positive. It suggests meniscus injury, and a popping sound combined with pain during external rotation indicates a lesion of the medial meniscus; a popping sound combined with pain during internal rotation suggests injury of the lateral meniscus. False positive should be noted, congenital disc meniscus or meniscus thickening, also can have a popping sound, but generally no pain.
38, extension limitation test: Helfet sign When the knee meniscus injury has interlocking, the joint can not be fully extended, as shown by straightening the tibial ramus is not externally rotated, but maintained on the midline of the patella.
39.Localized pressure pain: McGregor sign When the medial meniscus is injured, there are obvious pressure points on the joint surface in the middle of the medial collateral ligament.
40. Knee extension test: Pisani sign A mass in the lateral joint space of the knee that disappears on knee extension and appears on knee flexion. It may be a lateral meniscal cyst.
41. Finger pressure test: Fimbrill-fisher sign The examiner places the fingertip in the joint space in front of the medial collateral ligament and rotates the lower leg in flexion several times, or extends the knee at the same time. If the medial meniscus is damaged, an object can be felt moving under the finger and may be accompanied by pain and friction sounds.
42, grinding test: Appley sign patient prone, bend the knee 90 °, the examiner hands hold the patient’s foot, the left leg press the affected leg, rotate and lift the affected knee, if there is pain, then the lateral collateral ligament injury; will knee down, and then rotate if there is pain, then the meniscus injury; slight flexion when pain. If there is pain when the knee is pressed down and then rotated, then it is a meniscal injury.
43.Macinotosh test: To check for anterior subluxation of the lateral tibial condyle. The examiner holds the patient’s foot with one hand and rotates it internally, while completely straightening the knee joint, and then flexing the knee joint with force to make the knee joint turn outward, and the dislocated tibia is reset at about 30° and there is a significant rebound, which is positive. This suggests an abnormality in the anterior cruciate ligament, which may be accompanied by other pathological changes.
44.Lateral motion test: Bochler sign The patient extends the knee, the examiner holds the ankle with one hand, holds the knee with the other hand, does the lateral motion, and when pushing inward, the lateral pain suggests lateral collateral ligament injury; when pushing outward, the medial pain suggests medial collateral ligament injury.
45.Drawer test: that is, drawer test. The patient lies supine and flexes the knee at 90°, the examiner sits lightly on the back of the patient’s foot (fixed), holds the upper part of the calf with both hands, and pulls backward and then forward. The anterior cruciate ligament can be pulled forward by more than 0.5 cm in case of rupture; the posterior cruciate ligament can be pushed backward by more than 0.5 cm in case of rupture. Placing the knee in flexion at 10-15° for the test (Lachman test) can increase the positive rate of this test and help determine the injury of the anterior internal or posterior external bundle of the ACL. The patient lies supine with the knee extended, the examiner fixes the knee with one hand and holds up the calf with the other hand, causing the knee to hyperextend, and those with pain may have an anterior meniscal horn injury, subpatellar fat pad hypertrophy, or femoral condyle cartilage injury.
47. Lannelongue sign: In tuberculosis of the knee joint, the joint movement is limited and the balance function is disrupted, so the gait is stagnant and incoherent, which is called muscle alertness sign.
48.Trompsons test: The patient’s feet are extended beyond the edge of the bed in prone position, and the examiner squeezes the calf gastrocnemius muscle with his hand, which can cause plantar flexion of the foot under normal circumstances, and if plantar flexion of the foot does not occur, it indicates a rupture of the Achilles tendon ligament. This test is a specific sign of acute Achilles tendon rupture.
49.Tinel sign：Yinel sign of median nerve at the wrist, the examiner’s finger tapping the median nerve at the wrist, the numbness of the innervation area is positive. This indicates that the median nerve is being compressed.
50.Phalen test：Patients with complete flexion of both wrists for 1~2 min, numbness or increased numbness in the innervated area of the median nerve is positive. It suggests carpal tunnel syndrome. The positivity rate is 70%.