CCEP Diagnosis & Assessment Techniques 3 — Questions and Answers
Question 1: In elbow assessment, a positive Cozen's test reproducing lateral elbow pain with resisted wrist extension suggests which diagnosis?
- Medial epicondylitis
- Lateral epicondylitis (tennis elbow) (Correct answer)
- Olecranon bursitis
- Cubital tunnel syndrome
Correct answer: Lateral epicondylitis (tennis elbow)
Cozen's test stresses the extensor carpi radialis brevis attachment at the lateral epicondyle, reproducing pain in lateral epicondylitis.
Question 2: Which nerve conduction finding is most diagnostic of cubital tunnel syndrome?
- Prolonged median nerve distal latency at wrist
- Slowed ulnar nerve conduction velocity across the elbow (Correct answer)
- Reduced radial nerve amplitude in forearm
- Prolonged peroneal nerve latency at fibular head
Correct answer: Slowed ulnar nerve conduction velocity across the elbow
Cubital tunnel syndrome causes slowed ulnar nerve conduction velocity specifically across the elbow segment, distinguishing it from distal ulnar nerve entrapment.
Question 3: During hip assessment, which test identifies iliopsoas tightness by extending the hip while the contralateral hip is held flexed to flatten the lumbar lordosis?
- FABER test
- Thomas test (Correct answer)
- Ober's test
- Trendelenburg test
Correct answer: Thomas test
The Thomas test eliminates lumbar compensation so that inability to fully extend the hip reveals true iliopsoas contracture.
Question 4: A Trendelenburg sign during single-leg stance indicates weakness of which muscle group?
- Ipsilateral adductors
- Contralateral hip abductors
- Ipsilateral hip abductors (Correct answer)
- Ipsilateral hip flexors
Correct answer: Ipsilateral hip abductors
A positive Trendelenburg sign occurs when the ipsilateral gluteus medius and minimus cannot prevent the contralateral pelvis from dropping during single-leg stance.
Question 5: Which radiographic measurement is used to assess subtalar joint alignment and evaluate flatfoot deformity on a lateral weight-bearing foot X-ray?
- Calcaneal pitch angle
- Meary's angle (talo-first metatarsal angle) (Correct answer)
- Böhler's angle
- Gissane's angle
Correct answer: Meary's angle (talo-first metatarsal angle)
Meary's angle measures the angle between the long axis of the talus and first metatarsal on lateral X-ray, with normal being near 0 degrees; deviation indicates pes planus or cavus.
Question 6: When evaluating for de Quervain's tenosynovitis, the Finkelstein test is positive when pain is reproduced by which maneuver?
- Passive wrist extension with thumb abducted
- Ulnar deviation of the wrist with the thumb held in the palm (Correct answer)
- Radial deviation with all fingers extended
- Passive forearm supination with wrist flexed
Correct answer: Ulnar deviation of the wrist with the thumb held in the palm
Finkelstein's test stretches the first dorsal compartment tendons (APL and EPB) by ulnar deviating the wrist while the thumb is held adducted in the fist.
Question 7: Which special test assesses for sacroiliac joint dysfunction by applying downward pressure on the ASIS bilaterally in a crossed direction?
- FABER test
- Gaenslen's test
- Compression/distraction test (Correct answer)
- Yeoman's test
Correct answer: Compression/distraction test
The sacroiliac compression and distraction tests stress the SI joint ligaments and joint surfaces to reproduce SI joint pain.
CCEP Diagnosis & Assessment Techniques 3
In elbow assessment, a positive Cozen's test reproducing lateral elbow pain with resisted wrist extension suggests which diagnosis?