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Book Details
Abstract
Now in its fifth edition, this core textbook continues to provide a comprehensive, systematic guide to the examination, assessment and clinical reasoning processes needed by clinicians when managing patients with musculoskeletal conditions. Nicola Petty is joined by Dionne Ryder in editing this new edition, which also sees an expanded number of specialist clinicians and academics contributing individual chapters.
Musculoskeletal Examination and Assessment provides an invaluable guide to the technical and clinical reasoning skills involved in the differential diagnosis of joint, nerve and muscle tissues within a psychosocial model of health and illness. Three initial chapters outline the subjective and physical examination as well as the clinical reasoning process. Subsequent chapters provide details of the examination for each region of the body. This edition is designed for physiotherapy and musculoskeletal therapy students as they get to grips with contemporary clinical practice.
- Provides a logical, clinically reasoned and evidence-enhanced approach to patient examination and assessment
- Emphasizes a patient-centred approach
- Presents key clinical concepts of leading therapists and researchers in the field of musculoskeletal therapy
- Many drawings and photographs visually demonstrate techniques while enhancing descriptions in the text
Clinical examples bring to life the clinical reasoning process
An emphasis on consideration of the patient’s perspective
Reliability, validity, sensitivity and specificity of the physical tests are highlighted
Vascular considerations are included throughout the text
References updated throughout
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Half title page | i | ||
| Dedication | ii | ||
| Musculoskeletal Examination and Assessment - Volume 1 | ii | ||
| Copyright Page | iv | ||
| Table Of Contents | v | ||
| Foreword | vii | ||
| Preface | ix | ||
| Contributors | xi | ||
| 1 Introduction | 1 | ||
| Reference | 2 | ||
| 2 Subjective Examination | 3 | ||
| Chapter Contents | 3 | ||
| Introduction | 3 | ||
| Clinical Reasoning Within Health and Disability | 3 | ||
| The Subjective Examination Step by Step | 4 | ||
| The Patient’s Perspective | 5 | ||
| Social History | 7 | ||
| Body Chart | 7 | ||
| Area of Current Symptoms | 7 | ||
| Areas Relevant to the Region Being Examined | 9 | ||
| Pain: the Most Common Presenting Symptom | 9 | ||
| Quality of the Pain | 9 | ||
| Recording Pain Intensity | 9 | ||
| Referred Pain | 10 | ||
| Abnormal Sensation | 13 | ||
| Constant or Intermittent Symptoms | 14 | ||
| Relationship of Symptoms | 14 | ||
| Behaviour of Symptoms | 14 | ||
| Aggravating and Easing Factors | 14 | ||
| Aggravating Factors | 14 | ||
| Easing Factors | 16 | ||
| Coping Strategies | 16 | ||
| Severity and Irritability of Symptoms | 17 | ||
| Severity of the Symptoms | 17 | ||
| Irritability of the Symptoms | 17 | ||
| Twenty-Four-Hour Behaviour of Symptoms | 18 | ||
| Night Symptoms | 18 | ||
| Morning Symptoms | 18 | ||
| Evening Symptoms | 18 | ||
| Stage of the Condition | 18 | ||
| Risk Factors for Chronicity | 19 | ||
| Pain-Related Risk Factors | 19 | ||
| Psychological Risk Factors | 19 | ||
| Social Risk Factors | 19 | ||
| Special Questions | 19 | ||
| General Health | 20 | ||
| Weight Loss | 20 | ||
| Cancer | 20 | ||
| Tuberculosis | 20 | ||
| Human Immunodeficiency Virus | 22 | ||
| Inflammatory Arthritis | 22 | ||
| Cardiovascular Disease | 22 | ||
| Respiratory Disease | 23 | ||
| Epilepsy | 23 | ||
| Thyroid Disease | 23 | ||
| Diabetes Mellitus | 23 | ||
| Osteoporosis | 23 | ||
| Neurological Symptoms | 23 | ||
| Neuropathic Pain Symptoms | 24 | ||
| Joint Hypermobility Syndrome (JHS) | 24 | ||
| Cervical Artery Dysfunction | 24 | ||
| Drug Therapy | 24 | ||
| Radiographs, Medical Imaging and Tests | 25 | ||
| Past Medical History | 25 | ||
| Family History | 25 | ||
| History of the Present Condition | 26 | ||
| Plan of the Physical Examination | 26 | ||
| Appendix 2.1 Clinical Reasoning Forms | 29 | ||
| Physical examination planning sheet (short version) | 29 | ||
| References | 32 | ||
| 3 Physical Examination | 35 | ||
| Chapter Contents | 35 | ||
| Introduction | 35 | ||
| Physical Examination Step by Step | 37 | ||
| Observation | 37 | ||
| Initial Observation | 37 | ||
| Formal Observation | 37 | ||
| Observation of Posture. | 37 | ||
| Hypermobility | 40 | ||
| Observation of Muscle Form. | 43 | ||
| Observation of Soft Tissues. | 43 | ||
| Observation of Gait. | 44 | ||
| Functional Ability/Physical Performance Tests | 44 | ||
| Joint Integrity Tests | 45 | ||
| Active Physiological Movements | 45 | ||
| Combined Movements | 48 | ||
| Repeated Movements | 50 | ||
| Speed of the Movement | 52 | ||
| Compression or Distraction | 52 | ||
| Sustained Movements | 52 | ||
| Injuring Movement | 52 | ||
| Differentiation Tests | 52 | ||
| Passive Physiological Movements | 52 | ||
| Muscle Tests | 53 | ||
| Muscle Strength | 55 | ||
| Muscle Control | 55 | ||
| Muscle Length | 56 | ||
| Isometric Muscle Testing | 56 | ||
| Other Muscle Tests | 63 | ||
| Sensorimotor/Neurological Tests | 64 | ||
| Integrity of the Nervous System | 64 | ||
| Reduced Sensory Input | 64 | ||
| Reduced Motor Impulses Along the Nerve | 64 | ||
| Reflex Changes | 64 | ||
| Procedure for Examining the Integrity of the Nervous System | 65 | ||
| Testing Sensation. | 65 | ||
| Testing Muscle Strength. | 68 | ||
| Reflex Testing. | 68 | ||
| Coordination. | 72 | ||
| Neural Sensitization Tests | 72 | ||
| Passive Neck Flexion. | 81 | ||
| Straight-Leg Raise. | 81 | ||
| Prone Knee Bend. | 81 | ||
| Femoral Nerve Slump Test. | 82 | ||
| Saphenous Nerve Test. | 83 | ||
| Slump. | 83 | ||
| Obturator Nerve Test. | 87 | ||
| Upper-Limb Neurodynamic Tests. | 88 | ||
| ulnt 1: median nerve bias (Fig. 3.31). | 88 | ||
| ulnt 2a: median nerve bias (Fig. 3.32). | 88 | ||
| ulnt 2b: radial nerve bias (Fig. 3.33). | 88 | ||
| ulnt 3: ulnar nerve bias (Fig. 3.34). | 88 | ||
| Nerve Tissue Palpation | 94 | ||
| Other Neurological Tests | 94 | ||
| Miscellaneous Tests | 94 | ||
| Palpation | 94 | ||
| Trigger Points (Fig. 3.36) | 100 | ||
| Accessory Movements | 100 | ||
| Movement Diagrams | 106 | ||
| Procedure for Drawing a Movement Diagram | 106 | ||
| To Draw Resistance (Fig. 3.39). | 106 | ||
| To Draw Pain Provocation (Fig. 3.42). | 107 | ||
| To Draw Muscle Spasm (Fig. 3.43). | 108 | ||
| Modifications to Accessory Movement Examination | 109 | ||
| Natural Apophyseal Glides (NAGs) | 111 | ||
| Sustained Natural Apophyseal Glides (SNAGs) | 112 | ||
| Mobilizations With Movement (MWMs) | 112 | ||
| Spinal Mobilization With Limb Movement (SMWLMs) | 112 | ||
| Completion of the Physical Examination | 112 | ||
| References | 118 | ||
| 4 Clinical Reasoning and Assessment | 122 | ||
| Chapter Contents | 122 | ||
| Introduction | 122 | ||
| Clinical Reasoning | 122 | ||
| Developments in Decision Making | 125 | ||
| Clinical Reasoning in the Subjective Examination | 127 | ||
| Activity and Participation Capabilities and Restrictions | 128 | ||
| Patients’ Perspectives on Their Pain Experience | 128 | ||
| Pathobiological Mechanisms | 129 | ||
| Tissue Responses and Healing | 129 | ||
| Pain Mechanisms | 130 | ||
| Physical Impairments and Associated Structure/Tissue Sources | 131 | ||
| Contributing Factors to the Development and Maintenance of the Problem | 132 | ||
| Precautions/Contraindications to Physical Examination, Treatment and Management | 133 | ||
| Severity and Irritability | 134 | ||
| Management Strategy and Treatment Planning | 136 | ||
| Prognosis | 142 | ||
| Conclusion | 142 | ||
| Acknowledgements | 142 | ||
| References | 142 | ||
| 5 Examination of the Temporomandibular Region | 146 | ||
| Chapter Contents | 146 | ||
| Introduction | 146 | ||
| Classification of TMD | 147 | ||
| Subjective Examination | 148 | ||
| Patients’ Perspective on Their Experience | 148 | ||
| Body Chart | 149 | ||
| Area of Current Symptoms | 149 | ||
| Areas Relevant to the Region Being Examined | 149 | ||
| Quality of Pain | 149 | ||
| Intensity of Pain | 149 | ||
| Abnormal Sensation | 149 | ||
| Constant or Intermittent Symptoms | 149 | ||
| Relationship of Symptoms | 149 | ||
| Behaviour of Symptoms | 149 | ||
| Aggravating Factors | 149 | ||
| Easing Factors | 150 | ||
| Parafunctional Habits | 150 | ||
| Twenty-Four-Hour Behaviour | 150 | ||
| Night Symptoms | 151 | ||
| Morning and Evening Symptoms. | 151 | ||
| Stage of the Condition | 151 | ||
| Special Questions and Red-Flag Screening | 151 | ||
| Clicking | 151 | ||
| Bruxism | 152 | ||
| Clenching | 152 | ||
| Dental Disorders | 152 | ||
| Trismus | 152 | ||
| Cranial Nerve Disorders | 152 | ||
| Cervical Arterial Dysfunction | 152 | ||
| Ear Symptoms | 153 | ||
| Headaches | 153 | ||
| History of the Present Condition | 153 | ||
| Past Medical History | 153 | ||
| Plan of the Physical Examination | 153 | ||
| Physical Examination | 154 | ||
| Observation | 154 | ||
| Informal Observation | 154 | ||
| Formal Observation | 154 | ||
| Observation of Posture | 154 | ||
| Observation of Muscle Form | 155 | ||
| Observation of the Intraoral Environment | 155 | ||
| Observation of Soft Tissues | 156 | ||
| Observation of the Patient’s Attitudes and Feelings | 156 | ||
| Active Physiological Movements | 156 | ||
| Passive Physiological Movements | 158 | ||
| Muscle Tests | 158 | ||
| Muscle Strength | 158 | ||
| Muscle Control | 158 | ||
| Isometric Muscle Testing | 160 | ||
| Endurance Testing | 160 | ||
| Neurological Tests | 160 | ||
| Integrity of Nervous System | 160 | ||
| Dermatomes/Peripheral Nerves | 160 | ||
| Myotomes/Peripheral Nerves | 160 | ||
| Reflex Testing | 160 | ||
| Neurodynamic Tests | 160 | ||
| Lingual Mandibular Reflex (CN V) | 162 | ||
| Miscellaneous Tests | 162 | ||
| Palpation | 162 | ||
| Accessory Movements | 162 | ||
| Other Tests for the Temporomandibular Joint | 163 | ||
| Dynamic Loading and Distraction | 163 | ||
| Bite Test (Biting on a Tongue Depressor Test) for Loading | 163 | ||
| Palpation via External Auditory Meatus | 163 | ||
| Completion of the Examination | 163 | ||
| Validity of Clinical Tests | 165 | ||
| Multidisciplinary Team Approach to TMD | 165 | ||
| References | 166 | ||
| 6 Examination of the Upper Cervical Region | 168 | ||
| Chapter Contents | 168 | ||
| Introduction | 168 | ||
| Symptoms Associated with the CCS | 170 | ||
| Headache | 171 | ||
| Cervical Arterial Dysfunction | 171 | ||
| Upper Cervical Instability (UCI) | 172 | ||
| Subjective Examination | 172 | ||
| The Patient’s Perspective | 173 | ||
| Body Chart | 173 | ||
| Area of Current Symptoms | 173 | ||
| Areas Relevant to the Region Being Examined | 174 | ||
| Quality of Pain | 174 | ||
| Intensity of Pain | 174 | ||
| Abnormal Sensation | 174 | ||
| Constant or Intermittent Symptoms | 174 | ||
| Relationship of Symptoms | 174 | ||
| Behaviour of Symptoms | 175 | ||
| Aggravating Factors | 175 | ||
| Easing Factors | 176 | ||
| Twenty-Four-Hour Behaviour of Symptoms | 176 | ||
| Night Symptoms | 176 | ||
| Morning and Evening Symptoms | 176 | ||
| Stage of the Condition | 176 | ||
| Special Questions and Red-Flag Screening | 176 | ||
| Cervical Arterial Dysfunction | 177 | ||
| Upper Cervical Instability | 178 | ||
| Family History | 179 | ||
| History of the Present Condition | 179 | ||
| Past Medical History | 179 | ||
| Plan of the Physical Examination | 180 | ||
| Physical Examination | 181 | ||
| Observation | 181 | ||
| Formal Observation | 181 | ||
| Observation of Posture. | 181 | ||
| Observation of Muscle Form. | 181 | ||
| Observation of Soft Tissues. | 182 | ||
| Active Physiological Movements | 182 | ||
| Additional Testing | 185 | ||
| Differentiation Tests | 185 | ||
| Neurological Testing | 185 | ||
| Integrity of the Nervous System | 186 | ||
| Dermatomes/Peripheral Nerves. | 186 | ||
| Myotomes/Peripheral Nerves. | 188 | ||
| Reflex Testing. | 188 | ||
| Pathological Reflex Testing for Upper Motor Neuron Lesion | 188 | ||
| Craniocervical Stability Testing | 188 | ||
| Sagittal-Plane Stress Tests | 188 | ||
| Coronal-Plane Stress Tests | 189 | ||
| Transverse-Plane Stress Tests | 190 | ||
| Distraction Test for the Tectorial Membrane | 191 | ||
| Palpation | 191 | ||
| Passive Intervertebral Examination | 191 | ||
| Passive Physiological Movements | 192 | ||
| Flexion–Extension PPIVM at C0–C1. | 192 | ||
| Side-Flexion PPIVM at C0–C1. | 192 | ||
| Rotation PPIVM at C1–C2. | 192 | ||
| Flexion–Rotation Test. | 192 | ||
| Accessory Movements | 192 | ||
| Accessory Movements as a Combined Technique. | 194 | ||
| Sustained Natural Apophyseal Glides (SNAGs). | 195 | ||
| Symptom Modification and Mini Treatments | 195 | ||
| Muscle Testing | 195 | ||
| Muscle Strength | 195 | ||
| Isotonic Testing. | 195 | ||
| Isometric Testing. | 196 | ||
| Sensorimotor Control | 196 | ||
| Sensorimotor Testing | 197 | ||
| Deep Cervical Muscle Testing. | 197 | ||
| Deep Craniocervical Flexors. | 197 | ||
| Deep Cervical Extensors. | 198 | ||
| Axioscapular Muscles. | 199 | ||
| Muscle Length | 199 | ||
| Neurodynamic Tests | 199 | ||
| Nerve Palpation | 200 | ||
| Cervical Arterial Dysfunction Testing | 200 | ||
| Completion of the Examination | 202 | ||
| Appendix 6.1 Headache Disability Index Questionnaire | 203 | ||
| Appendix 6.2 Headache Disability Questionnaire | 204 | ||
| References | 205 | ||
| 7 Examination of the Cervicothoracic Region | 208 | ||
| Chapter Contents | 208 | ||
| Introduction | 208 | ||
| Subjective Examination | 208 | ||
| Patients’ Perspective on Their Experience | 208 | ||
| Body Chart | 209 | ||
| Area of Current Symptoms | 209 | ||
| Areas Relevant to the Region Being Examined | 209 | ||
| Quality of Pain | 209 | ||
| Intensity of Pain | 209 | ||
| Abnormal Sensation | 209 | ||
| Constant or Intermittent Symptoms | 209 | ||
| Relationship of Symptoms | 209 | ||
| Behaviour of Symptoms | 210 | ||
| Aggravating Factors | 210 | ||
| Easing Factors | 210 | ||
| Twenty-Four-Hour Behaviour of Symptoms | 210 | ||
| Night Symptoms. | 210 | ||
| Morning and Evening Symptoms. | 210 | ||
| Stage of the Condition | 211 | ||
| Special Questions | 211 | ||
| Cervical Spine Fracture | 211 | ||
| Cervical Arterial Dysfunction | 211 | ||
| Family History | 211 | ||
| History of the Present Condition | 211 | ||
| Past Medical History | 212 | ||
| Plan of the Physical Examination | 212 | ||
| Physical Examination | 212 | ||
| Observation | 213 | ||
| Informal Observation | 213 | ||
| Formal Observation | 213 | ||
| Observation of Posture. | 213 | ||
| Observation of Muscle Form. | 213 | ||
| Observation of Soft Tissues. | 213 | ||
| Observation of the Patient’s Attitudes and Feelings. | 213 | ||
| Active Physiological Movements | 213 | ||
| Palpation | 216 | ||
| Passive Intervertebral Examination | 217 | ||
| Passive Physiological Movements | 218 | ||
| Passive Accessory Intervertebral Movements | 218 | ||
| Natural Apophyseal Glides (NAGs) | 220 | ||
| Reversed Natural Apophyseal Glides | 220 | ||
| Sustained Natural Apophyseal Glides (SNAGs) | 220 | ||
| Muscle Tests | 220 | ||
| Movement Control | 222 | ||
| Deep Cervical Muscle Testing. | 222 | ||
| Scapular Strength. | 222 | ||
| Isometric Muscle Testing | 222 | ||
| Muscle Length | 222 | ||
| Neurological Tests | 224 | ||
| Integrity of Nervous System | 224 | ||
| Dermatomes/Peripheral Nerves. | 224 | ||
| Myotomes/Peripheral Nerves. | 224 | ||
| Reflex Testing. | 224 | ||
| Neurodynamic Tests | 224 | ||
| Other Nerve Tests | 224 | ||
| Plantar Response to Test for an Upper Motor Neuron Lesion (Walton 1989). | 224 | ||
| Tinel’s Sign. | 224 | ||
| Sensorimotor Tests | 226 | ||
| Proprioception | 226 | ||
| Oculomotor Tests | 226 | ||
| Postural Stability | 227 | ||
| Miscellaneous Tests | 227 | ||
| Spurling’s Neck Compression Test | 227 | ||
| Shoulder Abduction Test | 227 | ||
| Cervical Arterial Dysfunction Testing | 227 | ||
| Blood Pressure | 227 | ||
| Functional Positional Testing | 227 | ||
| Cranial Nerve Examination | 228 | ||
| Test for Thoracic Outlet Syndrome | 228 | ||
| Completion of the Examination | 228 | ||
| References | 229 | ||
| 8 Examination of the Thoracic Region | 231 | ||
| Chapter Contents | 231 | ||
| Possible Causes of Pain and/or Limitation of Movement | 231 | ||
| Subjective Examination | 232 | ||
| Patients’ Perspective on Their Experience | 232 | ||
| Body Chart | 232 | ||
| Area of Current Symptoms | 232 | ||
| Areas Relevant to the Region Being Examined | 233 | ||
| Quality of Pain | 233 | ||
| Intensity of Pain | 233 | ||
| Abnormal Sensation | 233 | ||
| Constant or Intermittent Symptoms | 233 | ||
| Relationship of Symptoms | 233 | ||
| Behaviour of Symptoms | 233 | ||
| Aggravating Factors | 233 | ||
| Easing Factors | 233 | ||
| Twenty-Four-Hour Behaviour of Symptoms | 234 | ||
| Night Symptoms. | 234 | ||
| Morning and Evening Symptoms. | 234 | ||
| Stage of the Condition | 234 | ||
| Special Questions | 234 | ||
| General Health | 234 | ||
| Serious Pathology | 234 | ||
| Cancer. | 234 | ||
| Tuberculosis. | 234 | ||
| Osteoporosis. | 234 | ||
| Inflammatory Conditions. | 234 | ||
| Drug Therapy | 234 | ||
| Radiograph and Medical Imaging | 235 | ||
| Neurological Symptoms | 235 | ||
| Vascular Symptoms | 235 | ||
| History of the Present Condition | 235 | ||
| Past Medical History | 235 | ||
| Plan of the Physical Examination | 235 | ||
| Physical Examination | 236 | ||
| Observation | 236 | ||
| Informal Observation | 236 | ||
| Formal Observation | 236 | ||
| Observation of Posture. | 236 | ||
| Observation of Muscle Form. | 237 | ||
| Observation of Soft Tissues. | 237 | ||
| Observation of Gait. | 237 | ||
| Active Physiological Movements | 237 | ||
| Observation of Aggravating Functional Activities or Positions | 240 | ||
| Symptom Modification | 241 | ||
| Passive Physiological Movements | 241 | ||
| Muscle Tests | 241 | ||
| Muscle Strength | 241 | ||
| Muscle Control | 241 | ||
| Muscle Length | 242 | ||
| Neurological Testing | 242 | ||
| Neurological Integrity | 242 | ||
| Dermatomes/Peripheral Nerves. | 242 | ||
| Neurodynamic Tests | 242 | ||
| Central Nervous System Testing – Upper Motor Nerve Lesions | 242 | ||
| Plantar Response – Babinski’s Sign (Fuller 2013). | 242 | ||
| Clonus. | 242 | ||
| Miscellaneous Tests | 242 | ||
| Respiration | 242 | ||
| Vascular Tests | 243 | ||
| Palpation | 243 | ||
| Passive Accessory Intervertebral Movements | 243 | ||
| Examination of the Ribcage | 243 | ||
| Rib Mechanics During Respiration | 243 | ||
| Completion of the Examination | 246 | ||
| References | 248 | ||
| 9 Examination of the Shoulder Region | 249 | ||
| Chapter Contents | 249 | ||
| Introduction | 249 | ||
| Subjective Examination | 250 | ||
| Patients’ Perspectives on Their Experience | 250 | ||
| Body Chart | 250 | ||
| Area of Current Symptoms | 250 | ||
| Areas Relevant to the Region Being Examined | 250 | ||
| Quality of Pain | 250 | ||
| Intensity of Pain | 251 | ||
| Abnormal Sensation | 251 | ||
| Constant or Intermittent Symptoms | 251 | ||
| Relationship of Symptoms | 251 | ||
| Behaviour of Symptoms | 251 | ||
| Aggravating Factors | 251 | ||
| Easing Factors | 251 | ||
| Twenty-Four-Hour Behaviour of Symptoms | 251 | ||
| Night Symptoms. | 251 | ||
| Morning and Evening Symptoms. | 252 | ||
| Stage of the Condition | 252 | ||
| Special Questions | 252 | ||
| Previous Shoulder Dislocation | 252 | ||
| Neurological Symptoms | 252 | ||
| Vascular Symptoms | 252 | ||
| Cervical Artery Dysfunction (CAD) | 252 | ||
| History of the Present Condition | 252 | ||
| Past Medical History | 252 | ||
| General Health | 253 | ||
| Weight Loss | 253 | ||
| Rheumatoid Arthritis | 253 | ||
| Drug Therapy | 253 | ||
| Further Investigations | 253 | ||
| Plan of the Physical Examination | 253 | ||
| Physical Examination | 253 | ||
| Observation | 254 | ||
| Informal Observation | 254 | ||
| Formal Observation | 254 | ||
| Observation. | 254 | ||
| Active Physiological Movements | 254 | ||
| Capsular Pattern | 255 | ||
| Passive Physiological Movements | 256 | ||
| Posterior Shoulder Tightness | 256 | ||
| Joint Integrity Tests | 259 | ||
| Anterior Shoulder Instability | 259 | ||
| Anterior Shoulder Drawer Test (Gerber & Ganz 1984) (Fig. 9.7). | 259 | ||
| Apprehension Test (Fig. 9.8). | 260 | ||
| Load and Shift Test (Fig. 9.9). | 260 | ||
| Posterior Shoulder Instability | 260 | ||
| Posterior Drawer Test (Fig. 9.10). | 260 | ||
| Inferior Shoulder Instability | 261 | ||
| Sulcus Sign (Matsen et al. 1990) (Fig. 9.11). | 261 | ||
| Rotator Cuff Pathology Tests | 261 | ||
| Empty- and Full-Can Tests for Supraspinatus Tear or Tendinopathy (Jobe & Moynes 1982) (Fig. 9.12) | 261 | ||
| Gerber ‘Lift-Off’ for Subscapularis Tendinopathy (Fig. 9.13) | 261 | ||
| External Rotation Lag Sign for Full-Thickness Tears of the Supraspinatus and Infraspinatus (Hertel et al. 1996; Castoldi et al. 2009) (Fig. 9.14) | 262 | ||
| Biceps Tests | 262 | ||
| Speed’s Test for Bicipital Tendinopathy (Fig. 9.15) | 262 | ||
| Yergason’s Test (Fig. 9.16) | 262 | ||
| Superior Labral Anterior–Posterior (SLAP) Tests | 263 | ||
| Biceps Load Tests I and II (Fig. 9.17) | 263 | ||
| Passive Distraction Test (Schlechter et al. 2009) (Fig. 9.18) | 264 | ||
| Active Compression Test (O’Brien et al. 1998) (Fig. 9.19) | 264 | ||
| Shoulder Impingement Syndrome | 264 | ||
| Cluster Signs for Impingement | 266 | ||
| Muscle Tests | 266 | ||
| Muscle Strength | 266 | ||
| Isometric Muscle Testing for Assessing Muscle as a Source of Symptoms | 266 | ||
| Muscle Control | 266 | ||
| Muscle Length | 267 | ||
| Neurological Tests | 267 | ||
| Neurodynamic Tests | 267 | ||
| Vascular Tests | 267 | ||
| Allen Test | 267 | ||
| Adson’s Manoeuvre | 267 | ||
| Palpation of Pulses | 267 | ||
| Palpation | 267 | ||
| Accessory Movements | 268 | ||
| Completion of the Examination | 268 | ||
| References | 270 | ||
| 10 Examination of the Elbow Region | 273 | ||
| Chapter Contents | 273 | ||
| Introduction to the Elbow Region | 273 | ||
| Subjective Examination | 275 | ||
| Patients’ Perspective on Their Experience | 275 | ||
| Body Chart | 275 | ||
| Area of Current Symptoms | 275 | ||
| Areas Relevant to the Region Being Examined | 276 | ||
| Quality of Pain | 276 | ||
| Intensity of Pain | 276 | ||
| Abnormal Sensation | 276 | ||
| Constant or Intermittent Symptoms | 276 | ||
| Relationship of Symptoms | 276 | ||
| Behaviour of Symptoms | 276 | ||
| Aggravating Factors | 276 | ||
| Easing Factors | 277 | ||
| Twenty-Four-Hour Behaviour of Symptoms | 277 | ||
| Night Symptoms. | 277 | ||
| Morning and Evening Symptoms. | 277 | ||
| Stage of the Condition | 277 | ||
| Special Questions | 277 | ||
| Comorbidities and Serious Illness | 277 | ||
| Past Medical and Family History | 278 | ||
| Elbow Stiffness or Arthritic Conditions | 278 | ||
| Osteoporosis | 278 | ||
| Sudden Swelling | 278 | ||
| Neurological Symptoms | 278 | ||
| Radiography and Medical Imaging | 278 | ||
| History of the Present Condition | 278 | ||
| Plan of the Physical Examination | 279 | ||
| Precautions and Contraindications | 279 | ||
| Developing Working and Alternative Hypotheses | 279 | ||
| What Is the Predominant Pain Mechanism? | 279 | ||
| Sequence and Extent of Physical Tests | 280 | ||
| Physical Examination | 281 | ||
| Observation | 281 | ||
| Informal Observation | 281 | ||
| Formal Observation | 281 | ||
| Observation of Posture. | 281 | ||
| Observation of Bony Alignment. | 281 | ||
| Observation of Swelling. | 282 | ||
| Observation of Muscle Form. | 282 | ||
| Functional Testing | 282 | ||
| Active Physiological Movements | 282 | ||
| Symptom Modification or Differentiation Testing | 283 | ||
| Passive Physiological Movements | 283 | ||
| Joint Integrity Tests | 283 | ||
| Medial Collateral Ligament Testing | 284 | ||
| the valgus test. | 284 | ||
| Lateral Collateral Ligament Testing | 285 | ||
| Posterolateral Pivot Shift Apprehension Test (O’Driscoll et al. 1991). | 285 | ||
| Muscle Tests | 286 | ||
| Muscle Strength | 286 | ||
| Muscle Length | 287 | ||
| Isometric Muscle Testing | 288 | ||
| Special Tests | 288 | ||
| Lateral Epicondylalgia (Tennis Elbow Tests). | 288 | ||
| Symptom Modification for Lateral Epicondylalgia (Tennis Elbow). | 290 | ||
| Medial Epicondylalgia (Golfer’s Elbow Test). | 290 | ||
| Neurological Tests | 290 | ||
| Dermatomes/Peripheral Nerves | 290 | ||
| Myotomes/Peripheral Nerves | 290 | ||
| Reflex Testing | 291 | ||
| Neurodynamic Tests | 291 | ||
| Testing for Compression Neuropathy | 291 | ||
| Ulnar Nerve Compression Neuropathy Tests. | 291 | ||
| tinel’s test. | 291 | ||
| elbow flexion test for cubital tunnel syndrome. | 291 | ||
| Median Nerve Compression Neuropathy Tests. | 292 | ||
| pinch-grip test. | 292 | ||
| test for pronator syndrome. | 292 | ||
| test for supracondylar process syndrome. | 292 | ||
| Radial Nerve Compression Neuropathy Test. | 292 | ||
| test for radial tunnel syndrome. | 292 | ||
| Vascular Considerations in Examination and Assessment | 292 | ||
| Palpation of Pulses | 292 | ||
| Palpation | 292 | ||
| Suggested Approach to Systematic Palpation | 293 | ||
| Accessory Movements | 293 | ||
| Completion of the Examination | 293 | ||
| References | 297 | ||
| 11 Examination of the Wrist and Hand | 299 | ||
| Chapter Contents | 299 | ||
| Wrist and Hand: an Overview | 299 | ||
| Subjective Examination | 300 | ||
| Patients’ Perspectives on Their Experience | 300 | ||
| Body Chart | 300 | ||
| Area of Current Symptoms | 300 | ||
| Areas Relevant to the Region Being Examined | 301 | ||
| Quality of Symptoms | 301 | ||
| Intensity of Pain | 301 | ||
| Abnormal Sensation | 301 | ||
| Constant or Intermittent Symptoms | 301 | ||
| Relationship of Symptoms | 301 | ||
| Behaviour of Symptoms | 302 | ||
| Aggravating Factors | 302 | ||
| Easing Factors | 302 | ||
| Twenty-Four-Hour Behaviour of Symptoms | 302 | ||
| Night Symptoms. | 302 | ||
| Morning and Evening Symptoms. | 302 | ||
| Past Medical History/Family History | 302 | ||
| Special Questions | 303 | ||
| General Health | 303 | ||
| Serious Pathology | 303 | ||
| Inflammatory Arthritis | 303 | ||
| Thyroid Disease | 303 | ||
| Dupuytren’s Disease | 303 | ||
| Osteoporosis | 303 | ||
| Diabetes Mellitus | 303 | ||
| Radiograph and Medical Imaging | 303 | ||
| Drug History | 304 | ||
| History of the Present Condition | 304 | ||
| Plan of the Physical Examination | 304 | ||
| Physical Examination | 305 | ||
| Observation | 305 | ||
| Informal Observation | 305 | ||
| Formal Observation | 306 | ||
| Observation of Posture. | 306 | ||
| Observation of Muscle Form. | 306 | ||
| Observation of Soft Tissues. | 306 | ||
| Functional Testing | 307 | ||
| Active Physiological Movements | 307 | ||
| Symptom Modification | 308 | ||
| Passive Physiological Movements | 310 | ||
| Joint Integrity Tests | 310 | ||
| Watson (Scaphoid Shift) Test | 310 | ||
| Midcarpal Shift Test | 310 | ||
| Lunotriquetral Ballottement (Reagan’s) Test | 310 | ||
| Triangular Fibrocartilaginous Complex Load Test | 314 | ||
| Ligamentous Instability Test for the Joints of the Thumb and Fingers | 314 | ||
| Axial Compression Test (Grind Test) | 315 | ||
| Muscle Tests | 315 | ||
| Muscle Strength | 315 | ||
| Muscle Length | 316 | ||
| Tenodesis Action. | 316 | ||
| Intrinsic Muscle Tightness. | 316 | ||
| Extrinsic Muscle Tightness. | 316 | ||
| Isometric Muscle Testing | 317 | ||
| Other Muscle/Tendon Tests | 317 | ||
| Tests for De Quervain’s Disease. | 317 | ||
| Sweater Finger Sign Test. | 317 | ||
| Test for Flexor Digitorum Superficialis (FDS). | 317 | ||
| Neurological Testing | 317 | ||
| Integrity of the Nervous System | 317 | ||
| Dermatomes/Peripheral Nerves. | 317 | ||
| Myotomes/Peripheral Nerves. | 318 | ||
| Reflex Testing | 318 | ||
| Neurodynamic Tests | 318 | ||
| Other Nerve Tests | 318 | ||
| Median Nerve. | 318 | ||
| tinel’s sign (at the wrist). | 318 | ||
| phalen’s wrist flexion test. | 318 | ||
| modified carpal compression test. | 318 | ||
| Ulnar Nerve. | 319 | ||
| froment’s sign for ulnar nerve paralysis. | 319 | ||
| Radial Nerve. | 319 | ||
| Tests for Circulation and Swelling | 319 | ||
| Allen Test for the Radial and Ulnar Arteries at the Wrist | 319 | ||
| Figure-of-Eight Measurement | 319 | ||
| Palpation | 319 | ||
| Accessory Movements | 320 | ||
| Completion of the Examination | 323 | ||
| Acknowledgements | 325 | ||
| References | 325 | ||
| 12 Examination of the Lumbar Region | 327 | ||
| Chapter Contents | 327 | ||
| Subjective Examination | 328 | ||
| Patients’ Perspectives on Their Experience | 328 | ||
| Body Chart | 328 | ||
| Area of Current Symptoms | 328 | ||
| Areas Relevant to the Region Being Examined | 328 | ||
| Quality of Pain | 328 | ||
| Intensity of Pain | 328 | ||
| Abnormal Sensation | 328 | ||
| Constant or Intermittent Symptoms | 329 | ||
| Relationship of Symptoms | 329 | ||
| Behaviour of Symptoms | 329 | ||
| Aggravating Factors | 329 | ||
| Easing Factors | 329 | ||
| Twenty-Four-Hour Behaviour of Symptoms | 330 | ||
| Night Symptoms. | 330 | ||
| Morning and Evening Symptoms. | 331 | ||
| Stage of the Condition | 331 | ||
| Special Questions | 331 | ||
| Neurological Symptoms | 331 | ||
| Family History | 331 | ||
| History of the Present Condition | 331 | ||
| Past Medical History | 332 | ||
| General Health | 332 | ||
| Weight Loss | 332 | ||
| Serious Pathology | 332 | ||
| Cardiovascular Disease | 332 | ||
| Blood Pressure | 332 | ||
| Respiratory Disease | 332 | ||
| Diabetes | 332 | ||
| Epilepsy | 332 | ||
| Osteoporosis | 332 | ||
| Previous Surgery | 332 | ||
| Drug Therapy | 332 | ||
| X-Ray and Medical Imaging | 333 | ||
| Plan of the Physical Examination | 333 | ||
| Physical Examination | 333 | ||
| Observation | 334 | ||
| Informal Observation | 334 | ||
| Formal Observation | 334 | ||
| Active Physiological Movements | 334 | ||
| Passive Physiological Movements | 338 | ||
| Joint Integrity Tests | 339 | ||
| Muscle Tests | 339 | ||
| Muscle Strength | 339 | ||
| Muscle Control | 340 | ||
| Muscle Length | 341 | ||
| Neurological Tests | 341 | ||
| Integrity of the Nervous System | 341 | ||
| Dermatomes/Peripheral Nerves | 341 | ||
| Myotomes/Peripheral Nerves | 343 | ||
| Reflex Testing | 343 | ||
| Neural Sensitization Tests | 343 | ||
| Other Nerve Tests | 343 | ||
| Plantar Response to Test for an Upper Motor Neuron Lesion (Walton 1989). | 343 | ||
| Clonus. | 344 | ||
| Coordination. | 344 | ||
| Cauda Equina Syndrome. | 344 | ||
| Miscellaneous Tests | 344 | ||
| Vascular Tests | 344 | ||
| Leg Length | 344 | ||
| Palpation | 344 | ||
| Passive Accessory Intervertebral Movements | 344 | ||
| Completion of the Examination | 346 | ||
| References | 347 | ||
| 13 Examination of the Pelvis | 349 | ||
| Chapter Contents | 349 | ||
| Introduction to the Pelvic Region | 349 | ||
| Subjective Examination | 351 | ||
| Patients’ Perspective on Their Experience | 352 | ||
| Body Chart | 352 | ||
| Area of Current Symptoms | 352 | ||
| Areas Relevant to the Region Being Examined | 352 | ||
| Quality of Symptoms | 352 | ||
| Intensity of Pain | 352 | ||
| Abnormal Sensation | 352 | ||
| Constant or Intermittent Symptoms | 353 | ||
| Relationship of Symptoms | 353 | ||
| Behaviour of Symptoms | 353 | ||
| Aggravating Factors | 353 | ||
| Easing Factors | 353 | ||
| Twenty-Four-Hour Behaviour of Symptoms | 354 | ||
| Night Symptoms. | 354 | ||
| Morning and Evening Symptoms. | 354 | ||
| Stage of the Condition | 354 | ||
| Special Questions | 354 | ||
| General Health | 354 | ||
| Obstetric History | 354 | ||
| Neurological Symptoms | 355 | ||
| History of the Present Condition | 355 | ||
| Past Medical History | 355 | ||
| Radiography and Medical Imaging | 355 | ||
| Plan of the Physical Examination | 356 | ||
| Physical Examination | 356 | ||
| Observation | 357 | ||
| Informal Observation | 357 | ||
| Formal Observation | 357 | ||
| Functional Testing | 357 | ||
| Active Physiological Movements | 357 | ||
| Standing Hip Flexion Test (Gillet Test) (Fig. 13.4) (Greenman 1996) | 357 | ||
| Active Straight-Leg Raise (ASLR) Test (Fig. 13.5A) (Mens et al. 2001, 2002) | 358 | ||
| Muscle Tests | 359 | ||
| Muscle Strength | 359 | ||
| Muscle Length | 359 | ||
| The Pelvic Floor | 360 | ||
| Neurological Tests | 360 | ||
| Nerve Tissue Palpation | 360 | ||
| Pain Provocation Tests | 360 | ||
| Thigh Thrust Test/Posterior Shear Test/Posterior Pelvic Pain Provocation (P4) (Fig. 13.6) (Laslett et al. 2005) | 360 | ||
| Compression Test/Posterior Gapping (Fig. 13.7) (Laslett et al. 2005) | 361 | ||
| Distraction/Anterior Gapping Test (Laslett & Williams 1994; Hengeveld & Banks 2005; Magee 2014) | 361 | ||
| Gaenslen’s/Pelvic Torsion Test (Fig. 13.8) | 361 | ||
| Sacral Thrust Test (Fig. 13.9) (Laslett & Williams 1994; Laslett et al. 2005) | 361 | ||
| FABER Test (Fig. 13.10) (van der Wurff et al. 2006) | 362 | ||
| Palpation | 362 | ||
| Palpation of the Long Dorsal Ligament (Vleeming 2008) | 363 | ||
| Passive Accessory Movements | 363 | ||
| Completion of the Examination | 363 | ||
| References | 364 | ||
| 14 Examination of the Hip Region | 366 | ||
| Chapter Contents | 366 | ||
| Introduction | 366 | ||
| Subjective Examination | 367 | ||
| Patients’ Perspectives and Experiences | 367 | ||
| Body Chart | 367 | ||
| Area of Current Symptoms | 367 | ||
| Areas Relevant to the Region Being Examined | 367 | ||
| Quality of Pain | 367 | ||
| Intensity of Pain | 367 | ||
| Abnormal Sensation | 367 | ||
| Constant or Intermittent Symptoms | 367 | ||
| Relationship of Symptoms | 367 | ||
| Behaviour of Symptoms | 368 | ||
| Aggravating Factors | 368 | ||
| Easing Factors | 368 | ||
| Twenty-Four-Hour Behaviour of Symptoms | 368 | ||
| Night Symptoms. | 368 | ||
| Morning and Evening Symptoms. | 369 | ||
| Special Questions | 369 | ||
| Squatting | 369 | ||
| Locking/Catching | 369 | ||
| Crepitus | 369 | ||
| Neurological Symptoms | 369 | ||
| History of the Present Condition | 369 | ||
| Past Medical History | 370 | ||
| General Health | 370 | ||
| Weight Loss | 370 | ||
| Serious Pathology | 370 | ||
| Inflammatory Arthritis | 370 | ||
| Family History | 370 | ||
| Cardiovascular Disease | 370 | ||
| Respiratory Disease | 370 | ||
| Diabetes | 370 | ||
| Epilepsy | 370 | ||
| Thyroid Disease | 370 | ||
| Osteoporosis | 370 | ||
| Previous Surgery | 370 | ||
| Drug History | 370 | ||
| Steroids. | 371 | ||
| Anticoagulants. | 371 | ||
| Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). | 371 | ||
| Plan of the Physical Examination | 371 | ||
| Physical Examination | 372 | ||
| Observation | 372 | ||
| Informal Observation | 372 | ||
| Formal Observation | 372 | ||
| Observation of Posture. | 372 | ||
| Observation of Muscle Form. | 373 | ||
| Observation of Soft Tissues. | 373 | ||
| Observation of Balance. | 373 | ||
| Observation of Gait. | 373 | ||
| Observation of Function. | 373 | ||
| Active Physiological Movements | 373 | ||
| Passive Physiological Movements | 375 | ||
| Tests for Intraarticular Structures | 375 | ||
| Hip Impingement | 375 | ||
| Internal Rotation Over Pressure (IROP) | 377 | ||
| Flexion Adduction Internal Rotation (FADDIR) | 377 | ||
| Flexion Abduction External Rotation (FABER) | 377 | ||
| Fracture | 377 | ||
| Patellar Pubic Percussion Test | 378 | ||
| Fulcrum Test | 378 | ||
| Tests for Extraarticular Structures | 378 | ||
| Gluteal Tendinopathy | 378 | ||
| Resisted External Derotation Test | 379 | ||
| Sustained Single-Leg Stance | 379 | ||
| Sports-Related Chronic Groin Pain | 379 | ||
| Double Adductor Test | 379 | ||
| Squeeze Test | 380 | ||
| Muscle Tests | 380 | ||
| Muscle Strength | 380 | ||
| Muscle Control | 380 | ||
| Muscle Length | 380 | ||
| Isometric Muscle Testing | 381 | ||
| Neurological Tests | 381 | ||
| Integrity of the Nervous System | 381 | ||
| Dermatomes/Peripheral Nerves. | 381 | ||
| Myotomes/Peripheral Nerves. | 381 | ||
| Reflex Testing. | 381 | ||
| Neurodynamic Tests | 381 | ||
| Miscellaneous Tests | 381 | ||
| Vascular Tests | 381 | ||
| Leg Length | 381 | ||
| Palpation | 382 | ||
| Accessory Movements | 382 | ||
| Symptom Modification | 382 | ||
| A Worked Example of Symptom Modification: Trochanteric Pain | 383 | ||
| Completion of the Examination | 386 | ||
| References | 387 | ||
| 15 Examination of the Knee Region | 389 | ||
| Chapter Contents | 389 | ||
| Introduction | 389 | ||
| Subjective Examination | 390 | ||
| Patients’ Perspectives on Their Experiences | 390 | ||
| Observation of the Patient’s Attitudes and Feelings | 390 | ||
| Body Chart | 390 | ||
| Area of Current Symptoms | 390 | ||
| Areas Relevant to the Region Being Examined | 390 | ||
| Quality of Pain | 390 | ||
| Intensity of Pain | 390 | ||
| Depth of Pain | 390 | ||
| Abnormal Sensation | 390 | ||
| Constant or Intermittent Symptoms | 391 | ||
| Relationship of Symptoms | 391 | ||
| Behaviour of Symptoms | 391 | ||
| Aggravating Factors | 391 | ||
| Easing Factors | 391 | ||
| Twenty-Four-Hour Behaviour of Symptoms | 392 | ||
| Night Symptoms. | 392 | ||
| Morning and Evening Symptoms. | 392 | ||
| Special Questions | 392 | ||
| Swelling | 392 | ||
| Giving Way | 392 | ||
| Locking | 392 | ||
| Crepitus | 392 | ||
| Neurological Symptoms | 393 | ||
| History of the Present Condition | 393 | ||
| Past Medical History | 393 | ||
| General Health | 393 | ||
| Weight Loss. | 393 | ||
| Serious Pathology. | 393 | ||
| Inflammatory Arthritis. | 394 | ||
| Family History | 394 | ||
| Cardiovascular Disease | 394 | ||
| Respiratory Disease | 394 | ||
| Diabetes | 395 | ||
| Epilepsy | 395 | ||
| Thyroid Disease | 395 | ||
| Osteoporosis | 395 | ||
| Previous Surgery | 395 | ||
| Drug History | 395 | ||
| Steroids. | 395 | ||
| Anticoagulants. | 395 | ||
| Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). | 395 | ||
| Plan of the Physical Examination | 395 | ||
| Physical Examination | 396 | ||
| Observation | 397 | ||
| Informal Observation | 397 | ||
| Formal Observation | 397 | ||
| Observation of Posture. | 397 | ||
| Observation of Muscle Form. | 397 | ||
| Observation of Soft Tissues. | 398 | ||
| Observation of Balance. | 398 | ||
| Observation of Gait. | 398 | ||
| Joint Effusion Tests | 398 | ||
| Patellar Tap Test | 398 | ||
| Sweep Test | 398 | ||
| Joint Integrity Tests | 398 | ||
| Collateral Stability Tests | 398 | ||
| Valgus Stress Tests. | 398 | ||
| Varus Stress Tests. | 399 | ||
| Anterior Stability Tests | 399 | ||
| Lachman Test. | 400 | ||
| Anterior Drawer Test. | 400 | ||
| Pivot Shift Test. | 401 | ||
| Posterior Stability Tests | 401 | ||
| Posterior Drawer Test. | 401 | ||
| Dial Test. | 402 | ||
| Meniscal Tests | 402 | ||
| McMurray Test | 402 | ||
| Thessaly Test | 403 | ||
| Joint Line Tenderness | 404 | ||
| Patellofemoral Tests | 404 | ||
| Clarke Test | 404 | ||
| Fairbank’s Apprehension Test | 404 | ||
| Active Physiological Movements | 404 | ||
| Passive Physiological Movements | 405 | ||
| Muscle Tests | 406 | ||
| Muscle Strength | 407 | ||
| Muscle Length | 407 | ||
| Isometric Muscle Testing | 407 | ||
| Muscle Control | 407 | ||
| Neurological Tests | 407 | ||
| Integrity of the Nervous System | 407 | ||
| Dermatomes/Peripheral Nerves. | 407 | ||
| Myotomes/Peripheral Nerves. | 407 | ||
| Reflex Testing. | 408 | ||
| Neurodynamic Tests | 408 | ||
| Miscellaneous Tests | 408 | ||
| Vascular Tests | 408 | ||
| Leg Length | 408 | ||
| Palpation | 408 | ||
| Increased or Decreased Prominence of Bones | 409 | ||
| Accessory Movements | 410 | ||
| Symptom Modification | 410 | ||
| A Worked Example of Symptom Modification: Anterior Knee Pain | 410 | ||
| Completion of the Examination | 415 | ||
| References | 416 | ||
| 16 Examination of the Foot and Ankle | 418 | ||
| Chapter Contents | 418 | ||
| The Foot and Ankle: An Overview | 418 | ||
| Subjective Examination | 419 | ||
| Patients’ Perspectives on Their Experience | 419 | ||
| Social History | 420 | ||
| Body Chart | 420 | ||
| Area of Current Symptoms | 420 | ||
| Areas Relevant to the Region Being Examined | 421 | ||
| Quality of Symptoms | 421 | ||
| Intensity of Pain | 421 | ||
| Abnormal Sensation | 421 | ||
| Constant or Intermittent Symptoms | 421 | ||
| Relationship of Symptoms | 421 | ||
| Establish the Depth of the Pain | 421 | ||
| Behaviour of Symptoms | 422 | ||
| Aggravating Factors | 422 | ||
| Easing Factors | 422 | ||
| Twenty-Four-Hour Behaviour of Symptoms | 423 | ||
| Night Symptoms. | 423 | ||
| Morning and Evening Symptoms. | 423 | ||
| Stage of the Condition | 423 | ||
| Special Questions | 423 | ||
| General Health | 423 | ||
| Weight Loss | 423 | ||
| Serious Pathology | 423 | ||
| Osteoporosis | 423 | ||
| Inflammatory Arthritis | 424 | ||
| Cardiovascular Disease | 424 | ||
| Respiratory Disease | 424 | ||
| Diabetes Mellitus | 424 | ||
| Neurological Symptoms if a Spinal Lesion Is Suspected | 424 | ||
| Joint Hypermobility Syndrome | 424 | ||
| Drug History | 424 | ||
| Past Medical History | 424 | ||
| Family History | 424 | ||
| Radiography and Medical Imaging | 425 | ||
| History of the Present Condition | 425 | ||
| Plan of the Physical Examination | 426 | ||
| Physical Examination | 427 | ||
| Observation | 427 | ||
| Informal Observation | 427 | ||
| Formal Observation | 427 | ||
| Observation of Posture. | 427 | ||
| Observation of Foot and Ankle Alignment. | 427 | ||
| Observation of Muscle Form. | 428 | ||
| Observation of Soft Tissues. | 428 | ||
| Functional Testing | 429 | ||
| Observation of Gait | 429 | ||
| Summary of Gait Analysis | 430 | ||
| Joint Integrity Tests | 430 | ||
| Anterior Drawer Sign | 430 | ||
| Talar Tilt | 431 | ||
| Cotton Test | 431 | ||
| External Rotation Stress Test (Kleiger Test) | 432 | ||
| Squeeze Test | 432 | ||
| Active Physiological Movements | 432 | ||
| Weight-Bearing Lunge Test | 433 | ||
| Passive Physiological Movements | 435 | ||
| Muscle Tests | 435 | ||
| Muscle Strength | 435 | ||
| Muscle Length | 436 | ||
| Isometric Muscle Testing | 436 | ||
| Other Muscle Tests | 436 | ||
| Thompson’s Test for Achilles Tendon Rupture. | 436 | ||
| Matles Test for Achilles Tendon Rupture. | 436 | ||
| Neurological Tests | 436 | ||
| Integrity of the Nervous System | 436 | ||
| Dermatomes/Peripheral Nerves. | 437 | ||
| Myotomes/Peripheral Nerves. | 437 | ||
| Reflex Testing. | 437 | ||
| Neurodynamic Tests | 437 | ||
| Nerve Palpation | 437 | ||
| Tests for Circulation and Swelling | 437 | ||
| Vascular Tests | 437 | ||
| Wells Score for Suspected Deep-Vein Thrombosis. | 437 | ||
| Figure-of-Eight Ankle Measurement. | 438 | ||
| Miscellaneous Tests of the Foot and Ankle | 438 | ||
| Anterior Impingement Sign of the Talocrural Joint | 438 | ||
| Mulders Click Test for Morton’s Neuroma | 439 | ||
| Star Excursion Balance Test (SEBT) | 439 | ||
| Palpation | 439 | ||
| Accessory Movements | 439 | ||
| Symptom Modification and Mobilizations With Movements | 440 | ||
| Inferior Tibiofibular Joint | 440 | ||
| Plantarflexion of the Ankle Joint | 440 | ||
| Dorsiflexion of the Ankle Joint | 440 | ||
| Completion of the Examination | 440 | ||
| Acknowledgements | 450 | ||
| References | 450 | ||
| Index | 453 | ||
| A | 453 | ||
| B | 454 | ||
| C | 454 | ||
| D | 456 | ||
| E | 456 | ||
| F | 457 | ||
| G | 458 | ||
| H | 459 | ||
| I | 459 | ||
| J | 460 | ||
| K | 460 | ||
| L | 461 | ||
| M | 461 | ||
| N | 463 | ||
| O | 463 | ||
| P | 464 | ||
| Q | 466 | ||
| R | 466 | ||
| S | 467 | ||
| T | 469 | ||
| U | 471 | ||
| V | 471 | ||
| W | 472 | ||
| X | 472 | ||
| Y | 472 | ||
| Z | 472 |