Additional Information
Book Details
Abstract
From an interdisciplinary author team now including orthopedic surgeons, PM&R specialists, and primary care and sports medicine experts, the second edition of Musculoskeletal Physical Examination: An Evidence-Based Approach educates physicians on how to give the most thorough physical examinations by understanding the "why" behind each type of exam. In-depth coverage of today's newest tests and techniques keeps you current in practice, and a new section titled "Author’s Preferred Approach" guides you through difficult areas of examination.
- Provides complete coverage of every musculoskeletal physical examination.
- Easy-to-use tables summarize and compare the evidence for specificity and sensitivity of each test for each condition.
- Utilizes over 200 illustrations to clearly depict each test.
- Includes in-depth coverage of today's newest tests, including the Thessaly test, Milking test, and Bear hug test.
- Distinguished author team now includes orthopedic surgeons, PM&R specialists, and primary care sports medicine experts.
- New section titled "Author’s Preferred Approach" guides readers through difficult areas of examination.
- Thorough updates and revisions made throughout each chapter keep you current in the field.
- Full-color figures enhance visual clarity.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| IFC_Excon pin page | IFC2 | ||
| Musculoskeletal Physical Examination | i | ||
| Copyright Page | iv | ||
| Contributors | v | ||
| Foreword | vii | ||
| Preface | viii | ||
| Table Of Contents | ix | ||
| Video Table of Contents | x | ||
| Introduction An Evidence-Based Approach to the Musculoskeletal Physical Examination | 1 | ||
| References | 2 | ||
| 1 Reliability and Validity of Physical Examinations | 4 | ||
| Introduction | 4 | ||
| Validity | 4 | ||
| Reliability | 5 | ||
| Specificity and Sensitivity | 5 | ||
| Positive and Negative Predictive Values | 6 | ||
| Summary | 6 | ||
| References | 6 | ||
| 2 Sensory, Motor, and Reflex Examination | 8 | ||
| Introduction | 8 | ||
| Sensory Examination | 8 | ||
| Provocative Maneuvers | 10 | ||
| Motor Examination | 10 | ||
| Other Measurement Tools | 11 | ||
| Functional Measures | 12 | ||
| Examination of Reflexes | 12 | ||
| Pathological Reflexes | 13 | ||
| Clonus | 13 | ||
| Plantar Reflex | 13 | ||
| Hoffman’s Reflex | 14 | ||
| Conclusion | 15 | ||
| References | 15 | ||
| 3 Physical Examination of the Cervical Spine | 18 | ||
| Introduction | 18 | ||
| Inspection | 18 | ||
| Palpation | 18 | ||
| Range of Motion | 19 | ||
| Neuromuscular Evaluation | 19 | ||
| Cervical Spine Tests That Provide or Relieve Pain | 19 | ||
| Spurling Neck Compression Test | 19 | ||
| Shoulder Abduction Test | 22 | ||
| Neck Distraction Test | 22 | ||
| Lhermitte Sign | 23 | ||
| Hoffmann’s Sign | 23 | ||
| Thoracic Outlet Syndrome | 25 | ||
| Adson Test | 25 | ||
| Wright’s Hyperabduction Test | 25 | ||
| Roos Test | 26 | ||
| Costoclavicular Test | 27 | ||
| Author’s Preferred Approach | 27 | ||
| Conclusion | 28 | ||
| References | 29 | ||
| 4 Physical Examination of the Shoulder | 31 | ||
| Introduction | 31 | ||
| Examination of the Shoulder | 31 | ||
| Inspection | 31 | ||
| Palpation | 31 | ||
| Range of Motion Testing | 31 | ||
| Muscles, Innervations, and Biomechanics | 35 | ||
| Scapular Biomechanics | 36 | ||
| Tests of Rotator Cuff Strength and Integrity | 36 | ||
| Empty Can Test | 38 | ||
| Full Can Test | 39 | ||
| Drop Arm Test | 39 | ||
| Test of Infraspinatus and Teres Minor Integrity | 39 | ||
| Patte Test (Video 4-3) | 39 | ||
| Tests of Subscapularis Strength | 40 | ||
| Lift-Off Test | 40 | ||
| Lift-Off Lag Sign | 40 | ||
| Bear Hug Test (Video 4-5) | 40 | ||
| Tests of Scapular Pathology | 40 | ||
| Lateral Scapular Slide Test (Video 4-6) | 43 | ||
| Isometric Pinch Test | 43 | ||
| Scapular Assistance Test (Video 4-7) | 44 | ||
| Scapular Retraction Test | 44 | ||
| Tests of the Biceps Tendon | 44 | ||
| Ludington Test | 44 | ||
| Yergason’s Test | 44 | ||
| Speed’s Test | 44 | ||
| Tests of Rotator Cuff Disease | 46 | ||
| Neer Sign | 46 | ||
| The Painful Arc | 46 | ||
| Neer Subacromial Injection Test | 46 | ||
| Hawkins Test (Video 4-11) | 48 | ||
| Yocum’s Test | 49 | ||
| Tests for Anterior Shoulder Instability | 49 | ||
| Apprehension Test | 51 | ||
| Jobe Relocation Test (Fowler Test) | 52 | ||
| Anterior Release Test or “Surprise Test” | 52 | ||
| Fulcrum Test | 53 | ||
| Anterior Drawer Test | 53 | ||
| Load and Shift Test | 54 | ||
| Tests for Posterior Shoulder Instability | 54 | ||
| Posterior Drawer Test | 55 | ||
| Posterior Apprehension Sign | 56 | ||
| Jerk Test | 56 | ||
| Tests for Inferior Shoulder Instability | 57 | ||
| Sulcus Sign (Video 4-16) | 57 | ||
| Hyperabduction Test | 58 | ||
| Tests for Labral Pathology | 58 | ||
| Active Compression (O’Brien) Test (Video 4-17) | 62 | ||
| Dynamic Shear Test | 63 | ||
| Biceps Load Test | 64 | ||
| Biceps Load Test II | 64 | ||
| New Pain Provocation Test (Video 4-20) | 64 | ||
| Crank Test | 65 | ||
| Anterior Slide Test (Video 4-22) | 65 | ||
| Compression-Rotation Test | 66 | ||
| Clunk Test | 66 | ||
| Tests of the AC Joint | 66 | ||
| Crossed-Arm Adduction (Apley Scarf Test) | 68 | ||
| Active Compression Test | 68 | ||
| Resisted Arm Extension Test | 68 | ||
| Author’s Preferred Approach | 69 | ||
| Conclusion | 69 | ||
| References | 69 | ||
| 5 Physical Examination of the Elbow | 72 | ||
| Introduction | 72 | ||
| Anatomy | 72 | ||
| The Elbow Joint | 72 | ||
| Osseous Anatomy | 72 | ||
| Ligamentous Anatomy | 72 | ||
| Elbow and Forearm Musculature | 74 | ||
| Extensor Group | 75 | ||
| Nerves in the Upper Extremity | 76 | ||
| Musculocutaneous Nerve | 76 | ||
| Median Nerve | 76 | ||
| Ulnar Nerve | 76 | ||
| Radial Nerve | 77 | ||
| Inspection | 77 | ||
| Palpation | 77 | ||
| Examination of Nerve Compression Syndromes | 78 | ||
| Median Nerve Lesions | 78 | ||
| Pronator Syndrome | 78 | ||
| Ulnar Nerve Lesions | 79 | ||
| Radial Nerve Lesions | 79 | ||
| Physical Examination of the Elbow | 79 | ||
| Examination of Lateral Epicondylitis | 79 | ||
| Extensor Carpi Radialis Brevis Test or Tennis Elbow Test | 80 | ||
| Resisted Middle-Finger Extension Test | 80 | ||
| Medial Epicondylitis | 80 | ||
| Resisted Wrist Flexion and Pronation | 80 | ||
| Tests for Biceps Tendon Rupture | 80 | ||
| Elbow Instability | 81 | ||
| Posterolateral Rotatory Instability of the Elbow | 82 | ||
| Lateral Collateral Ligament Complex Examination | 82 | ||
| Evaluation for Medial Instability | 83 | ||
| Other Special Tests for the Elbow | 83 | ||
| Radiocapitellar Osteochondritis Dissecans | 84 | ||
| Summary | 86 | ||
| References | 86 | ||
| 6 Examination of the Wrist and Hand | 88 | ||
| Introduction | 88 | ||
| Anatomy | 88 | ||
| Bones, Ligament, and Joints | 88 | ||
| Distal Radioulnar Joint | 88 | ||
| Radiocarpal Joint | 88 | ||
| Ligaments | 88 | ||
| Carpal Tunnel | 89 | ||
| Guyon Canal | 89 | ||
| Muscles | 90 | ||
| Forearm Based (Extrinsics) | 90 | ||
| Flexor Group | 90 | ||
| Extensor Group | 91 | ||
| Hand Based (Intrinsics) | 92 | ||
| Nerves | 93 | ||
| Median Nerve | 93 | ||
| Ulnar Nerve | 94 | ||
| Radial Nerve | 94 | ||
| Dermatomes | 95 | ||
| Examination | 95 | ||
| Palpation | 95 | ||
| Wrist | 95 | ||
| Volar/Flexor Surface of the Wrist | 95 | ||
| Dorsal/Extensor Surface of the Wrist | 95 | ||
| Hand | 97 | ||
| Range of Motion | 98 | ||
| Neurologic Examination | 98 | ||
| Strength | 98 | ||
| Sensation | 99 | ||
| Tinel Sign | 99 | ||
| Arteries | 99 | ||
| Special Tests | 100 | ||
| Carpal Tunnel Syndrome | 100 | ||
| De Quervain Tenosynovitis | 100 | ||
| Finkelstein’s (Table 6.1) | 100 | ||
| Scapholunate Instability | 101 | ||
| Lunotriquetral Instability | 101 | ||
| Lunotriquetral Ballottement Test | 101 | ||
| Shear Test for LunoTriquetral Instability | 102 | ||
| Triangular Fibrocartilaginous Complex | 102 | ||
| Ulnocarpal Stress Test | 102 | ||
| Foveal Sign | 103 | ||
| Extensor Carpi Ulnaris Instability | 103 | ||
| Thumb Carpometacarpal Arthritis | 103 | ||
| Thumb Metacarpal Phalanges Instability | 103 | ||
| Metacarpal Phalangeal Joints | 104 | ||
| Proximal and Distal Interphalangeal Joints | 104 | ||
| Authors’ Preferred Approach | 104 | ||
| Conclusion | 104 | ||
| References | 104 | ||
| 7 Physical Examination of the Lumbar Spine and Sacroiliac Joint | 106 | ||
| Introduction | 106 | ||
| Anatomy and Biomechanics | 106 | ||
| Physical Exam of the Lumbar Spine | 108 | ||
| Inspection (Video 7-1) | 108 | ||
| Palpation | 109 | ||
| Range of Motion | 109 | ||
| Fingertips-to-Floor | 110 | ||
| Schober Test and Modifications Thereof | 110 | ||
| Modified Schober Test | 111 | ||
| Modified–Modified Schober Test | 112 | ||
| Inclinometer | 112 | ||
| Neurologic Examination | 112 | ||
| Manual Motor Testing (Video 7-2) | 112 | ||
| Sensory Examination (Video 7-3) | 116 | ||
| Reflex Examination (Video 7-4) | 118 | ||
| Provocative Lumbar Spine Maneuvers | 120 | ||
| Straight-Leg Raise Test (Video 7-5) | 120 | ||
| Crossed Straight-Leg Raise Test (Video 7-6) | 121 | ||
| Bowstring Sign (Video 7-7) | 125 | ||
| The Slump Test (Video 7-8) | 125 | ||
| The Ankle Dorsiflexion Test (Braggard Sign) (Video 7-9) | 126 | ||
| Femoral Nerve Stretch Test (Video 7-10) | 126 | ||
| The Crossed Femoral Nerve Test (Video 7-11) | 126 | ||
| Waddell Signs (Video 7-12) | 128 | ||
| Tenderness | 128 | ||
| Simulation Tests | 128 | ||
| Distraction Tests | 128 | ||
| Regional Disturbances | 129 | ||
| Overreaction | 129 | ||
| The Hoover Test (Video 7-13) | 129 | ||
| Other Tests | 129 | ||
| The Sacroiliac Joint | 129 | ||
| Physical Exam of the Sacroiliac Joint | 129 | ||
| Sacroiliac Motion Tests (Video 7-14) | 129 | ||
| Standing Flexion Test | 129 | ||
| Seated Flexion Test (Video 7-15) | 131 | ||
| Gillet Test (One-Leg Stork Test) (Video 7-16) | 132 | ||
| Other Tests | 133 | ||
| Palpation | 133 | ||
| Fortin Finger Test | 133 | ||
| Sacroiliac Provocative Maneuvers | 133 | ||
| Compression Test (Video 7-17) | 133 | ||
| Gapping Test (Distraction) (Video 7-18) | 134 | ||
| Patrick (FABERE) Test (Video 7-19) | 134 | ||
| Gaenslen Test (Video 7-20) | 135 | ||
| Cranial Shear Test | 135 | ||
| Thigh Thrust (Posterior Shear, PPPP, P4, Posterior Pelvic Pain Provocation) Test (Video 7-21) | 136 | ||
| Midline Sacral Thrust | 136 | ||
| Active Straight-Leg Raise and Active Assisted Straight-Leg Raise (Video 7-22) | 137 | ||
| Combined Tests | 137 | ||
| Authors’ Preferred Approach | 138 | ||
| References | 140 | ||
| 8 Physical Examination of the Pelvis and Hip | 145 | ||
| Introduction | 145 | ||
| Inspection, Palpation, and Range of Motion | 145 | ||
| Muscle Tightness or Pathology of the Lumbopelvic Region (Table 8.1) | 146 | ||
| Thomas Test (Video 8-1) | 149 | ||
| Modified Thomas Test | 149 | ||
| Prone Hip Extension (Staheli Test) | 150 | ||
| Measurements of the Pelvifemoral Angle | 151 | ||
| Ely Tests and Rectus Femoris Contracture Test (Videos 8-2, 8-3) | 151 | ||
| Ober Test (Video 8-4) | 152 | ||
| Piriformis Tests (Video 8-5) | 153 | ||
| Active Piriformis Test (Pace Test) | 153 | ||
| Passive Piriformis Stretch Test | 153 | ||
| Straight-Leg Raise (Lasègue’s Sign) | 154 | ||
| Popliteal Angle or Knee Extension Angle (Video 8-6) | 154 | ||
| Trendelenburg Sign or Test | 155 | ||
| Resisted Internal Rotation of the Thigh (Resisted External Derotation) | 156 | ||
| Tests for Intra-Articular or Periarticular Hip Joint Pathology (Table 8.2) | 156 | ||
| FABERE Test | 156 | ||
| Resisted Straight Leg Raise (Stinchfield Test) (Video 8-7) | 160 | ||
| Impingement Testing | 160 | ||
| Anterior Impingement Test | 160 | ||
| Flexion–Internal Rotation Test | 161 | ||
| Flexion–Internal Rotation–Axial Compression or Internal Rotation Over Pressure | 161 | ||
| Flexion–Adduction–Axial Compression Test | 162 | ||
| Passive Supine Rotation Test (Log Roll) (Video 8-8) | 162 | ||
| Flexion-Extension Maneuvers | 162 | ||
| Fitzgerald’s Test | 162 | ||
| Quadrant Test (Hip Scour Test) (Video 8-9) | 162 | ||
| Posterior and Lateral Rim Impingement Test | 163 | ||
| Axial Hip Distraction (Video 8-10) | 163 | ||
| Athletic Pubalgia Tests (Table 8.3) | 163 | ||
| Resisted Sit-up (Video 8-11) | 163 | ||
| Resisted Hip Adduction (Video 8-12) | 163 | ||
| Tests for Leg-Length Discrepancy (Table 8.4) | 165 | ||
| Direct Leg-Length Discrepancy Method (Video 8-13) | 165 | ||
| Indirect leg-length discrepancy Method | 167 | ||
| Tests for Femoral Stress Fractures (Table 8.5) | 168 | ||
| Fulcrum Test (Video 4-13) | 168 | ||
| Hop Test | 168 | ||
| Author’s Preferred Approach | 169 | ||
| Standing | 169 | ||
| Sitting | 169 | ||
| Supine | 169 | ||
| Lateral | 169 | ||
| Prone | 169 | ||
| References | 169 | ||
| 9 Physical Examination of the Knee | 173 | ||
| Introduction | 173 | ||
| Inspection | 173 | ||
| Range of Motion | 173 | ||
| Palpation | 174 | ||
| Medial Knee | 174 | ||
| 10 Physical Examination of the Foot and Ankle | 199 | ||
| Introduction | 199 | ||
| General Definitions | 199 | ||
| Anatomy and Physical Examination | 199 | ||
| Inspection | 199 | ||
| Palpation | 201 | ||
| Bones and Joints | 201 | ||
| Soft Tissue Structures | 202 | ||
| The Great Toe | 203 | ||
| The Lesser Toes | 204 | ||
| Tendons | 204 | ||
| Vascular Examination | 204 | ||
| Biomechanics | 204 | ||
| Tibiotalar Joint | 204 | ||
| Talocalcaneal Joint | 205 | ||
| Transverse Tarsal Joint (Chopart Joint) | 205 | ||
| Tarsometatarsal Joint (Lisfranc Joint) | 206 | ||
| Extrinsic Muscles of the Ankle and Foot | 206 | ||
| Plantar Flexion | 206 | ||
| Dorsiflexion | 206 | ||
| Inversion and Supination | 206 | ||
| Eversion and Pronation | 206 | ||
| Intrinsic Muscles of the Foot | 206 | ||
| Interphalangeal and Metatarsophalangeal Flexion | 206 | ||
| Metatarsophalangeal Extension | 206 | ||
| Neurologic Examination | 206 | ||
| Special Tests for the Ankle and Foot | 208 | ||
| Ankle Stability Testing | 208 | ||
| Anterior Drawer (Video 10-1) | 208 | ||
| Anterolateral Drawer Test | 210 | ||
| Talar Tilt (Video 10-2) | 210 | ||
| Syndesmosis Injuries | 210 | ||
| External Rotation or Kleiger Test (Video 10-3) | 211 | ||
| Syndesmotic Ligament Palpation Test (Video 10-4) | 212 | ||
| Syndesmosis Squeeze Test (Video 10-5) | 212 | ||
| Ankle Synovitis and Impingement Syndromes | 212 | ||
| Achilles Tendon Rupture (Table 10.6) | 213 | ||
| Thompson Test (Simmonds–Thompson or Squeeze Test) (Video 10-6) | 213 | ||
| Matles Test | 214 | ||
| Palpation Test | 214 | ||
| Summary | 214 | ||
| Authors’ Preferred Approach | 214 | ||
| Achilles Tendon | 214 | ||
| Instability | 214 | ||
| Conclusion | 215 | ||
| References | 215 | ||
| Index | 219 | ||
| A | 219 | ||
| B | 219 | ||
| C | 219 | ||
| D | 219 | ||
| E | 220 | ||
| F | 220 | ||
| G | 220 | ||
| H | 220 | ||
| I | 220 | ||
| J | 220 | ||
| K | 220 | ||
| L | 220 | ||
| M | 221 | ||
| N | 221 | ||
| O | 221 | ||
| P | 221 | ||
| Q | 221 | ||
| R | 221 | ||
| S | 222 | ||
| T | 222 | ||
| U | 222 | ||
| V | 222 | ||
| W | 222 | ||
| Y | 222 | ||
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