1.Cervical spine separation test: cervical spine lesion
Examination method: The patient takes a sitting position, the doctor is located at his side, one hand holds the patient under the chin, the other hand holds the occiput, and then gradually tracts the head upward.
Positive signs: the patient feels pain relief in the neck and upper limbs.
2.Intervertebral foraminal squeeze test: cervical spine has lesions
Inspection method: the patient takes a sitting position, the doctor is located in its rear, the fingers of both hands are embedded in each other, with the palm of the hand under the top of the patient’s head, the two forearms palm side of the patient’s head on both sides of the protection, to each different direction squeeze.
Positive signs: when squeezed, pain in the neck or upper limbs appears to increase.
3.Knock-top test: cervical vertebrae with lesions
Examination method: The patient takes a sitting position, the doctor stands behind him, and places the palm of one hand on the top of the patient’s head, while the other hand holds a fist and taps the back of the palm of the padded hand.
Positive features, knock out when the patient’s neck or upper limbs appear pain or numbness.
4, breath-holding abdominal test: cervical spine lesions
Examination method: The patient takes a supine position and holds his breath, contracting the abdominal muscles to increase abdominal pressure.
Positive signs: the patient has pain in the neck.
5.Swallowing test: anterior cervical hematoma, posterior pharyngeal wall abscess, cervical fracture movement, cervical dislocation, cervical tumor
Examination method: The patient takes a sitting position, the doctor is located on one side, and the patient is asked to make swallowing movements.
Positive signs: difficulty or pain in swallowing.
6.Inhalation head turn test: cervical rib or front and middle oblique muscle contracture and other lesions
Examination method: The patient takes a sitting position. The doctor is located behind the patient, holding his wrist with one hand and using his fingers to feel the radial artery of the patient, while the upper limb is abducted, posteriorly extended and externally rotated. The patient is then asked to inhale deeply and turn the chin of the head to the side being examined.
Positive sign: The physician feels that the radial artery pulsation of the patient is significantly weakened or disappeared.
7, brachial nerve pull test: cervical spine syndrome patients with brachial plexus nerve compression
Examination method: The patient is seated with the head slightly flexed. The doctor stands on the patient’s head on the examined side, pushes the head to the opposite side, while the other hand holds the wrist on that side for relative traction, and the brachial plexus nerve is stretched.
Positive signs: radiating pain and numbness in the affected limb.
8.Straight leg raise test: lumbar synostosis, pear-shaped muscle syndrome, intraspinal tumor and other lesions
Examination method: The patient is in supine position, with both lower limbs straight and close together. The doctor is located on one side, and the patient is instructed to straighten and raise one lower limb to the maximum, and then put it back to the examination bed, and then straighten and raise the other lower limb to the maximum, and compare the two sides, when normal, the angle between the leg and the examination bed is above 60°, and the two sides are equal.
Positive signs: both sides are not equal less than 60°, one side of the leg elevation process appears in the lower limb radiological pain.
9.Straight leg elevation strengthening test: simple sciatic nerve compression
Examination method: The patient takes the supine position, the doctor is located on his side, one hand holds the patient’s ankle, in the straight leg elevation if the patient appears to have pain in the lumbar region, lower the affected leg by 5 to 10° until the pain is reduced or disappears, and suddenly flex the dorsal foot up.
Positive signs: the patient’s lumbar pain and lower extremity radiating pain reappear.
10.Supine knee and hip flexion test: lumbosacral ligament injury or lumbosacral joint lesion
Examination method: The patient is in supine position with both legs together, the doctor is located on one side, and is instructed to flex the hip and knee as much as possible. The physician presses the patient’s knees with both hands to bring the thighs as close to the abdominal wall as possible.
Positive sign: pain in the lumbosacral region.
11.Pick up the object test: there is a lesion in the lumbar region of the child
Examination method: first take an object on the ground, let the child pick it up, the doctor pay attention to observe its picking up posture. If upright and bending to pick up the object is normal.
Positive signs: when the child’s waist can not be bent forward, the child bends the hip, bend the knee, waist squatting, picking up things with the other hand.
12, prone back extension test: in children with spinal lesions
Examination method: the patient is lying prone on the bed, the two lower limbs together, the doctor lift their feet, the appearance of lumbar hyperextension, the spine is curved back extension state is normal.
Positive signs: when lifting the feet, the spine is straight, and the thighs, pelvis and abdominal wall leave the bed at the same time.
13.Pelvic crush test: fracture or sacroiliac joint lesion
Examination method: The patient is in supine position, the doctor stands on one side, and both hands squeeze the pelvis to the midline at the same time on both sides of the iliac wing respectively.
Positive sign: pain occurs in the pelvis.
14.Bedside test (Geisland test): Sacroiliac joint has lesion
Examination method: The patient lies on his back, the doctor moves the patient to the side of the examination bed, one hip is placed outside the bed, let the leg on that side sag on the side of the bed, the other leg is flexed, fix the pelvis, the doctor protects the patient with his body, at the same time presses the sagging thigh with one hand to make the hip posteriorly extend.
Positive sign: pain occurs in the sacroiliac joint.
15.”4″ test—Pacheco test: Sacroiliac joint is diseased
Examination method: The patient lies on his back, the knee joint of the lower limb is flexed, the hip joint is flexed, abducted and externally rotated, the foot is placed on the knee joint of the other side, both lower feet are in the shape of “4”, the doctor puts one hand on the inner side of the flexed knee joint, the other hand is placed in front of the lateral anterior superior iliac spine, and then both hands are pressed downward.
Positive sign: pain at the sacroiliac joint.
16.Pelvic separation test: endopelvic fracture or sacroiliac joint lesion
Examination method: The patient is in supine position, the doctor places both hands in front of the anterior superior iliac spine on both sides, and both hands push downward at the same time.
Positive sign: pain appears.
17.Slant plate test: sacral hip lesion
Examination method: The affected side is supine, one leg is straight, the other leg is hip and knee flexed at 90° each, the doctor holds the knee flexed on that side with one hand, the other hand presses the shoulder on the same side, the doctor pushes the patient’s leg inward with the hand holding the knee and makes the hip joint on that side rotate inward.
Positive sign: pain occurs in the sacroiliac joint.
18.Single hip posterior extension test: sacroiliac joint lesion
Examination method: The patient is lying prone, both lower limbs are straight, the doctor presses the back of the patient’s sacrum with one hand, holds one side of the thigh with the elbow of the other hand, holds the lower leg of that side with the hand and lifts the lower limb upward, so that the hip is passively posteriorly extended.
Positive feature: pain at the sacroiliac joint.
19.Heel and hip test: lumbosacral joint lesion
Examination method: The patient is in prone position with both lower limbs straight, the doctor stands on one side, holds the patient’s ankle with one hand and makes him bend the knee and heel to touch the hip.
Positive signs: pain appears in the lumbosacral region, even the pelvis, and the waist is lifted along with it.
20.Jerk up test: nerve root compression in the lumbar region
Examination method: The patient takes a supine position, the doctor stands on one side, and instructs the patient to hold the abdomen with the foot and shoulder, so that the waist and pelvis leave the bed, while making a cough.
Positive signs: pain in the lumbar region and radiating pain in the lower limbs.
21.Flexion neck test: lumbar nerve root compression
Examination method: The patient takes a sitting or supine position, both lower limbs are straight, the doctor is located on one side, and the patient makes active or passive neck flexion for 1-2 minutes.
Positive signs: lumbar pain, radiating pain in the lower limbs.
22.Hitch shoulder test (Duga test): shoulder dislocation
Examination method: The patient is asked to bend the elbow in sitting or standing position and put the hand on the opposite shoulder.
Positive sign: The hand can reach the opposite shoulder, but the elbow cannot be close to the chest wall; or the elbow can be close to the chest wall, but the hand cannot reach the opposite shoulder.
23.Falling wall test: there is a rupture in the shoulder muscle key sleeve
Examination method: Take the patient in three dimensions during the examination, abduct the affected limb by 90°, and then make it drop slowly.
Positive sign: It cannot be lowered slowly and appears to fall suddenly straight to the side of the body.
24, biceps resistance test: biceps long head tendon slippage, biceps head muscle keyitis
Examination method: The patient takes a sitting position, the doctor is located in front of him, the patient is asked to bend the elbow 90°, the doctor holds the patient’s elbow with one hand, holds the wrist with one hand, and gives resistance to ask the patient to bend the elbow with force.
Positive signs: The biceps key slips out, or pain arises at the intertrochanteric sulcus.
25.Peripheral shoulder diameter measurement: shoulder dislocation
Examination method: The physician uses a soft ruler to measure the circumferential diameter from the patient’s shoulder peak around the axilla.
Positive sign: Increase in circumference.
26.Straight ruler test: Shoulder dislocation or scaphoid neck displacement fracture
Examination method: The physician applies a straightedge to the lateral side of the upper wall of the patient, with one end touching the lateral epicondyle of the humerus and the other end touching the greater tuberosity of the humerus.
Positive sign: The peak of the shoulder appears to be located on the line between the external supracondylar humerus and the greater tuberosity of the humerus.
27.Abduction test of shoulder joint
Examination method: The patient is placed in a sitting or standing position, and the physician is located on one side. The abduction activity of the shoulder joint is observed to generally identify the shoulder disease.
Signs and clinical significance.
1. Loss of shoulder joint function with severe pain is mostly suggestive of shoulder dislocation or fracture.
2. If there is pain in the shoulder joint from abduction to supination, it is usually suggestive of shoulder arthritis.
3.It is not painful at the beginning of abduction, but the more horizontal the shoulder is, the more painful it is, which mostly suggests shoulder joint adhesions.
4.When the shoulder is abducted at 30-60°, the affected deltoid muscle can be seen to contract significantly, but the upper limb cannot be abducted and the more force is applied, the more the shoulder is shrugged. If the passive abduction of the affected limb crosses 60°, the patient can actively lift the upper limb again, which mostly suggests a rupture or tear of the musculocutaneous key of the deltoid muscle.
5.Pain in abduction, but no pain in supination, mostly suggests subdeltoid bursitis.
6.No pain at the beginning of abduction, pain in the range of 60-120°, and no pain on the opposite side after crossing this range, mostly suggesting supraspinatus myositis.
7. Careful abduction movement with sudden pain is mostly suggestive of clavicle fracture.
28.Tension test of wrist extensor muscle: tennis elbow
Examination method: The patient takes a sitting position, the doctor is located in front of him, one hand holds the patient’s elbow, flexes the elbow 90°, forearm rotates forward, palm down half clenched fist, the other hand holds the back of the hand to make it passively flex the wrist, then applies resistance on the back of the patient’s hand and instructs the patient to extend the wrist.
Positive sign: pain occurs at the lateral epicondyle of the humerus.
29.Elbow joint lateral collateral ligament stability test
Examination method: The patient takes a sitting position, and the physician is located in front of him/her, holding the back of the patient’s elbow with one hand and the wrist with the other hand. Let the patient straighten the elbow joint, hold the patient’s wrist hand to make the forearm inward, and the hand holding the elbow to push the elbow joint outward, producing inward stress in the lateral elbow joint; conversely, hold the patient’s wrist hand to make the forearm abduct, and the hand holding the elbow to pull the elbow joint inward, producing outward stress in the medial elbow joint.
Signs and clinical significance.
If there is inward motion of the forearm when inversion stress is produced, it indicates a rupture of the lateral collateral ligament.
If there is abduction of the forearm when the valgus stress is generated, this indicates a rupture of the medial collateral ligament. When doing the above test, the
30.Percussion test (Tiree test): ulnar nerve with neuroma
Examination method: The patient is in a sitting position, the doctor is in front of him/her, and taps the ulnar nerve node with a percussion hammer.
Positive signs: produce pain radiating to the distal end, even from the forearm to the ulnar nerve distribution area of the hand.
31.Tennis elbow test (milky ear test): tennis elbow
Examination method: The patient takes a sitting or standing position, the doctor is located in front and behind him/her, and the patient is asked to bend the forearm slightly, make a half-clenched fist with the wrist joint flexed as much as possible, then rotate the forearm completely in front, and then straighten the elbow.
Positive sign: Pain occurs on the lateral side of the brachioradialis joint when the elbow is straightened.
32.Elbow triangle examination
Examination method: The patient is seated and the physician examines the relationship between the medial epicondyle of the humerus, the lateral epicondyle of the humerus and the ulnar eminence at the patient’s extended and flexed elbow, respectively.
Signs and clinical significance: Normally, in extension, the humeral medial and lateral epicondyles and ulnar eminence are in a straight line, and in flexion at 90°, the three form an isosceles triangle, called the elbow triangle, which loses its normal relationship when the elbow joint is posteriorly dislocated.
33.Carpal triangle cartilage squeeze test: triangle cartilage injury
Examination method: The patient takes a sitting position, flexes the elbow 90°, palm down, the doctor is located in front of the patient’s distal forearm with one hand, the other hand holds the palm of the hand, so that the affected hand is passively deflected to the ulnar side, and then extends and flexes the wrist joint, so that the ulnar side of the wrist joint is squeezed and ground.
Positive sign: Significant pain in the wrist joint.
34.Fist clenching test (Fingerstein test): radial stem stenosis tendinitis
Examination method: the patient takes a sitting position flexion 90 ° forearm neutral position clenched fist, and the thumb in the heart of the palm, the doctor is located in front of its one hand to hold the distal forearm, the other hand to hold the patient’s hand so that the wrist joint to the ulnar side of the wrist flexion.
Positive sign: severe pain at the radial styloid process.
35, superficial finger flexor test: tendon rupture or deficiency
Examination method: The patient takes a sitting position, the doctor is located in front of him/her, fix the examined finger in the straight position, and then ask the patient to flex the proximal interphalangeal joint of the finger to be examined. This allows the superficial finger flexors to move independently. If the joint flexes normally, the superficial flexor tendon is intact.
Positive sign: The joint cannot be flexed.
36, finger deep flexor test: finger deep flexor tendon rupture or the innervation of the muscle is impaired
Examination method: The patient takes a sitting position, the doctor is located in front of him, the patient’s metacarpophalangeal joint and proximal interphalangeal joint is fixed in the extension position, and then the patient flexes the distal interphalangeal joint. If normal flexion is achieved, the tendon is functional.
Positive sign: The interphalangeal joint cannot be flexed.
37.Flexion wrist test: carpal tunnel syndrome
Examination method: The patient takes a sitting position, the doctor is located in front of him/her, and the patient is asked to flex the wrist joint extremely.
Positive signs: numbness and pain in the fingers.
38.Hip joint weight-bearing function test (standing flexion and flexion knee test, Cun Delimber test)
Weakness or insufficiency of the gluteus medius muscle on the weight-bearing side. This test must be compared on both sides and is often used to diagnose post-polio, congenital hip dislocation, old hip dislocation, hip inversion, slipped epiphysis of femoral head necrosis and other diseases.
Examination method: The patient takes a standing position, the doctor is located behind, and the patient is asked to stand on one leg and keep the body upright. When one leg leaves the ground, the gluteus medius muscle on the weight-bearing side immediately contracts and lifts the pelvis on the opposite side, indicating that the gluteus medius muscle on the weight-bearing side is functioning normally.
Positive sign: The pelvis on the non-weight-bearing side is not elevated or even declines.
39, Iliotibial bundle contracture test (Ouyang test): contracture of the iliotibial bundle. Iliotibial fasciculus contracture after poliomyelitis
Examination method: The doctor is located in front of him/her, and he/she is asked to try to abduct the affected limb and then bend the knee 90° to loosen the iliotibial bundle, and then relax the abducted thigh, and the thigh descends to the inward position when normal.
Positive sign: the abducted thigh remains in the abducted position after relaxation and does not descend.
40, hip flexion contracture test (Toma test): hip flexion contracture deformity, mostly due to joint tuberculosis, rheumatoid arthritis and other diseases caused by
Examination method: The patient takes the suppressed position, both lower limbs are straight, the doctor is located on one side of the examination bed, holding the patient’s ankle with one hand, holding the knee with the other hand, asking the patient to flex the hip and knee on one side, so that the thigh is close to the abdominal wall and the waist is close to the bed.
Positive signs: the leg of the straightened side automatically leaves the bed, and the angle between the thigh and the bed is formed.
41.Lower limb shortening test (Ellis test): posterior dislocation of the hip joint or shortening of the femur and tibia
Examination method: The patient takes the supine position, both legs bend hip, bend knee together, both feet together, put on the bed surface, the doctor is located on one side to pay attention to the height of the two knees, such as the two knees equal height is normal.
Positive sign: one knee is lower than the other.
42.Telescope test (Dupuchon test): the child has congenital hip dislocation
Examination method: The patient is lying down, the doctor is located on one side with one hand to fix the pelvis, the other hand holds the knee to raise the thigh 30° and push and pull the femoral stem up and down.
Positive signs: those who perceive loosening sensation.
43.Reset hip test (Ortolani test): congenital hip dislocation in infants and children
Examination method: the child is lying down, the doctor holds the knee of the child with one hand, the middle finger and ring finger of the other hand press the greater trochanter, the thigh is flexed, abducted and externally rotated, the femoral head enters the acetabulum, the doctor then inwardly retracts, internally rotates and straightens the thigh of the child, the femoral head slides out of the acetabulum.
Positive signs: a resetting popping sound can be heard. The popping sound of dislocation can also be heard.
44, hip hyperextension test (psoas major muscle contracture test): psoas major muscle abscess, early tuberculosis of the hip joint, hip ankylosis
Examination method: patient prone position, bend the knee 90 °, the doctor position a hand to hold the ankle, lift the lower limb, so that the hip joint hyperextension.
Positive sign: the pelvis is also lifted.
45.Frog test: congenital hip dislocation in young children
Examination method: when examining the child lying on his back, make both knees and hips flexed at 90°, the doctor makes the child’s hips rotate to frog position, and the lateral contact of both lower limbs to the examination bed surface is normal.
Positive sign: the lateral side of one or both lower limbs cannot touch the bed surface.
46.Hip sitting line check femoral greater trochanter upward shift is mostly seen in hip dislocation, displaced femoral neck fracture, hip and other diseases.
How to check: the patient is lying on his side, the line from the anterior superior iliac spine to the sciatic tuberosity, the apex of the greater trochanter of the femur is exactly on the line when normal.
Positive sign: The greater trochanter exceeds this line.
The line between the anterior superior iliac spine and the sciatic tuberosity is called the Nenatron line
The iliofemoral line is called the Shoemaker line.
The point of intersection of the iliofemoral line extension is called the Capra intersection.
47.Iliofemoral line examination: the superior displacement of the greater trochanter of the femur, mostly seen in hip dislocation, displaced femoral neck fracture, hip inversion and other diseases.
Inspection method: the patient takes a suppressed lying position, the two lower limbs are straight and neutral, the anterior superior iliac spine on both sides is on the same plane, the doctor makes a line from both sides of the anterior superior iliac spine and the apex of the greater trochanter respectively, that is, the iliofemoral line. When normal, the two lines of extension intersect at the umbilicus or supraumbilical midline.
Positive signs: the extension line intersects under the umbilicus on the healthy side and deviates from the midline.
48.Briand’s triangle: upward displacement of the greater trochanter of the femur
How to check: The patient takes a supine position, makes a vertical line from the anterior superior iliac spine to the bed surface, draws a line from the apex of the greater trochanter parallel to the body and perpendicular to the upper line, connects the anterior superior iliac spine and the apex of the greater trochanter, which constitutes a right triangle, called Brean’s triangle. If the two sides of the right angle are equal, it is normal.
Positive sign: The distance between the plumb lines of the bed becomes shorter.
49.Palmar heel test: femoral neck fracture, hip dislocation or paraplegia.
Examination method: The patient is placed in a supine position with the lower limbs straight. The doctor is located on one side, and the patient is asked to place the heel on the doctor’s palm surface, under normal circumstances, the lower limb is in a neutral position straight up on the palm surface.
Positive signs: foot lateral to one side, in an externally rotated position.
50.Heel percussion test: hip joint lesion
Examination method: The patient is supine, with both lower limbs straight. The doctor is located on one side, one hand lifts the patient’s affected limb slightly, and the other hand punches his heel.
Positive sign: pain at the hip joint when hitting the heel.
51.Flexion knee and hip splitting test: share adductor syndrome
Examination method: the patient is supine, the doctor is located on one side, the patient is asked to flexion and external rotation of the two lower limbs, the two soles of the feet are opposite, the two lower limbs are abducted and externally rotated.
Positive signs: The two lower limbs are not easily separated completely, and pain is produced when they are passively separated.
52.Rotary squeeze test (McMurry test).
There are popping and pain on the lateral side, suggesting lateral meniscus injury.
The medial side has a popping sound and pain, suggesting medial meniscus injury.
Examination method: The patient lies on his back, the presser is located on one side holding the foot with one hand, fixing the knee joint with the other hand, making the patient’s knee extremely flexed, trying to make the long axis of the tibia rotate internally, the doctor’s hand fixing the knee joint is placed on the outside of the knee pushing the knee joint so that it is turned out, the lower leg is abducted and the knee joint is slowly straightened. Make the opposite side movements according to the above principles, make the knee externally rotated and inwardly turned, the lower leg inward, and then straighten the knee joint.
Positive signs: popping and pain in the knee joint.
53. Grinding and lifting test (Aprai test)
1. Squeeze and grind test: meniscal rupture or articular cartilage injury
Examination method: patient prone position, knee flexion 90 °, the doctor fixed the country fossa with one hand, the other hand holding the patient’s foot, downward pressure on the foot, so that the knee joint surface against the tight, and then for calf rotation action.
Positive sign: there is pain in the knee joint.
2.Lift test: lateral collateral ligament injury
Examination method: This test helps to identify whether the injury occurs in the meniscus or in the collateral ligament. The patient lies prone with the knee flexed at 90°, the doctor presses the lower thigh with one hand, holds the ankle of the affected limb with the other hand, lifts the lower leg, makes the knee leave the examination bed, and performs abduction, external rotation or internal retraction and internal rotation activities.
Positive sign: lateral or medial knee pain.
54. Flexion-knee rotation test (Tiberius-Fischer test): meniscal rupture
Examination method: The patient sits on the bedside with both knees flexed and feet down, the doctor is located in front of him/her and presses the thumb on the anterolateral side of the patient’s joint space, which is equivalent to the meniscus, and internally and externally rotates the patient’s lower leg with the other hand, repeatedly.
Positive sign: Suddenly feel an object moving under the thumb of the doctor and cause pain.
55.Lateral collateral ligament injury test: medial (lateral) collateral ligament injury or rupture of the knee joint
Examination method: check the patient supine position, knee straight, the doctor one hand to hold the side of the knee, the other hand to hold the ankle, and then make the calf for passive inward or abduction action. If the medial collateral ligament is examined, one hand is placed on the lateral side of the patient’s knee to push the knee inward and the other hand pulls the calf outward. If the lateral collateral ligament is examined, one hand is placed on the medial side of the knee to push the knee outward, and the other hand pulls the calf inward.
Positive signs: The knee joint produces a loose feeling and there is pain medially (laterally).
56. Meniscal gravity test: Meniscal injury or discoid meniscus
Examination method: When examining the lateral meniscus, the patient lies on his side, pads his thighs up, and makes his lower legs leave the bed, and instructs the patient to make flexion and extension movements of the knee joint, so that the lateral meniscus is squeezed and ground. Then, the patient is placed on the opposite side with the upper leg slightly abducted and the knee joint flexed and extended to squeeze and grind the medial meniscus, if there is no popping and pain, the medial meniscus is normal.
Positive signs: When examining the lateral meniscus, it is positive if there is pain or popping on the lateral side. When examining the medial meniscus, it is positive if there is a popping sound and medial pain.
57.Drawer test: whether there is a rupture of the cruciate ligament of the knee joint
Examination method: The patient is examined in a supine position with both knees flexed at 90°, the physician sits on the bedside, presses the patient’s dorsum of the foot with the thigh, and holds the proximal calf with both hands and pushes and pulls back and forth.
Positive signs: If the proximal end of the calf moves forward, it indicates a rupture of the anterior cruciate ligament; conversely, if there is excessive movement backward, it indicates a rupture of the posterior cruciate ligament.
58.Floating patella test: fluid accumulation in the knee joint cavity
Examination method: When the patient’s leg is straightened, the doctor presses one hand on the suprapatellar capsule and squeezes downward to confine the fluid to the joint cavity. Then use the thumb and middle finger of the other hand to fix the inner and outer edges of the patella, and the index finger to press the patella.
Positive signs: the patella can be felt as floating, sinking when pressed heavily and floating when the finger is released.
59.Interlocking sign
Examination method: Sitting or supine position, let the patient do knee flexion and extension activities several times.
Positive signs: joint pain and inability to flex and extend.
The meniscus is torn, displaced and the knee joint is interlocked. In this case, the lower leg is rotated internally and externally, the knee is flexed, and then the lower leg is rotated and straightened until the meniscus slips into the proper position. Until the knee joint can be flexed and extended freely. Then the interlock is relieved.
60.Squeeze calf triceps test: Achilles tendon rupture
Examination method: The patient lies prone with the foot hanging on the side of the examination bed, the doctor is located on one side and squeezes the triceps muscle of the patient’s calf with his hand, which can cause plantar flexion of the ankle when normal.
Positive sign: No plantarflexion activity.
61.Ankle dorsiflexion test
This test is a special test to identify gastrocnemius and flounder muscle contracture.
The test method: let the patient flex the knee joint, because the starting point of gastrocnemius muscle is above the knee joint line, at this time, the gastrocnemius muscle is relaxed, and the ankle joint can be dorsiflexed.
Positive sign (a): When the knee joint is straightened, the ankle joint cannot be dorsiflexed.
Clinical significance: contracture of the gastrocnemius muscle.
Positive sign (2): The ankle joint cannot be dorsiflexed if the knee is extended or flexed.
Clinical significance: contracture of the hallux valgus muscle.
62.Ankle extension test: deep vein thrombophlebitis in the lower leg
How to examine: Let the patient straighten the calf and then forcefully extend the ankle joint dorsally.
Positive sign: pain occurs in the calf muscle.
63.Forefoot crush test: metatarsal fracture
Examination method: The patient is in supine position, and the doctor holds the patient’s forefoot with his hand and squeezes it laterally.
Positive sign: severe pain occurs.
64.Heel axis measurement: foot inversion or valgus deformity
Examination method: patient standing position, if the midline of the lower leg and the longitudinal axis of the heel is the same as normal.
Positive sign: the heel axis is skewed to the lateral or medial side of the midline of the lower leg.
65.Measurement of the long axis of the foot and the two ankle lines: forefoot abduction deformity
Examination method: The patient is in supine position, and the long axis of the foot intersects with the two ankle lines from the plantar surface.
Positive signs: two lines intersecting at right angles.
66.Foot index measurement method
Inspection method: foot flat on the table, from the highest foot to the distance of the table for the height of the arch; from the heel to the tip of the second toe length of the foot.
Normal foot index: (arch height × 100 ÷ foot length) 29 – 31
Positive signs and clinical significance: flatfoot index is less than 29, and in severe cases, the index is below 25. High arch foot index is less than 31.
67.Foot top angle measurement
Inspection method: the first metatarsal head, the inner ankle, the heel node three points connected into a triangle, the top angle of 95 ° is normal.
Positive signs and clinical significance.
The parietal angle of high arched foot reaches about 60°.
The parietal angle of the flat foot is 105-120°.
The normal angle of the base on the side of the heel is 60°.
flatfoot is about 50-55°.
High arched foot about 65-70 °.
68.Foot inversion and valgus test.
Ipsilateral pain suggests a fracture of the medial or lateral ankle.
Pain on the opposite side suggests injury to the medial or lateral collateral ligament.
Examination method: The patient is in sitting or supine position, the doctor fixes the lower leg with one hand, holds the foot with the other hand and turns the ankle extremely inward or outward.
Positive signs: ipsilateral or contralateral pain is present.