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Pivot-shift test. The pivot-shift test [1] is one of the three major tests for assessing anterior cruciate injury or laxity, the other two being the anterior drawer and Lachman test. However, unlike the other two, it tests for instability, an important determinant as to how the knee will function. [1]
The pivot-shift test involves flexing the knee while holding onto the ankle and slightly rotating the tibia inwards. [28] In the anterior drawer test, the examiner flexes the knees to 90 degrees, sits on the person's feet, and gently pulls the tibia towards themself. [29] The Lachman test is performed by placing one hand on the person's thigh ...
Dial Test (posterolateral rotation test) - The dial test can be performed with a patient lying supine or prone. With the patient supine and the knees flexed 30° off the table, stabilize the thigh and externally rotate the foot. As the foot rotates, watch for external rotation of the tibial tubercle of the affected knee compared to the healthy ...
This function prevents anterior tibial subluxation of the lateral and medial tibiofemoral joints, which is important for the pivot-shift phenomenon. [6] The ACL has mechanoreceptors that detect changes in direction of movement, position of the knee joint, and changes in acceleration, speed, and tension. [7]
Distraction tests: positive tests are rechecked when the patient's attention is distracted, such as a straight leg raise test; Regional disturbances: regional weakness or sensory changes which deviate from accepted neuroanatomy; Overreaction: subjective signs regarding the patient's demeanor and reaction to testing
Hawkins–Kennedy test: a positive test indicates shoulder impingement syndrome; Empty beer can test: a positive test indicates rotator cuff tear, specifically, supraspinatus muscle tear; Drop arm test: a positive test indicates a supraspinatus tear; External Rotation test: a positive test indicates an infraspinatus or teres minor tear
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If the anterior movement of the affected knee is greater than the unaffected knee, then the anterior drawer test is positive. The Lachman test is more sensitive than the anterior drawer test. For the Lachman test, the person lies down in supine position with the knee flexed at 20 degrees and the heel touching the bed. The tibia is then pulled ...