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The elbow extension test is simple test that can be administered as part of the physical exam to help guide healthcare providers diagnosis and management of acute elbow fractures. The elbow extension test is performed when an elbow fracture, most commonly caused by trauma , is suspected as the source of pain and dysfunction.
To perform the test, a patient is asked to hold an object, usually a flat object such as a piece of paper, between the thumb and index finger (pinch grip). The examiner then attempts to pull the object out of the subject's hands. [2] A normal individual will be able to maintain a hold on the object without difficulty.
The patient needs to be in a seated position with the elbow flexed to 90°, forearm pronated (palm facing the ground), and the arm stabilized against the thorax. [ 2 ] [ 3 ] [ 4 ] The examiner places the stabilizing hand on the proximal portion of the humerus near the bicipital groove, and the resistance hand on the distal forearm and wrist.
Differentiation of the cause of Wartenberg's sign is based on associated clinical findings in the history and examination and sometimes involves investigations including radiographs and/or MRI of the cervical spine, elbow/wrist/hand and/or nerve conduction studies and EMG. [citation needed]
The Neer impingement test is a test designed to reproduce symptoms of rotator cuff impingement through flexing the shoulder and pressure application. Symptoms should be reproduced if there is a problem with the supraspinatus or biceps brachii. [1] This test is also associated with the Hawkins-Kennedy Test and Jobe's Test. [2]
The tests differ in the rotation of the arm; in the empty can test, the arm is rotated to full internal rotation (thumb down) and in the full can test, the arm is rotated to 45° external rotation, thumb up. [1] Once rotated, the clinician pushes down on either the wrists or the elbow, and the patient is instructed to resist the downward pressure.
Mulder's sign is a physical exam finding associated with Morton's neuroma, which may be elicited while the patient is in the supine position on the examination table. The pain of the neuroma, as well as a click, can be produced by squeezing the two metatarsal heads together with one hand, while concomitantly putting pressure on the interdigital space with the other hand.
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