Orthopedic Assessment & Diagnosis Flashcards

A patient demonstrates a positive dial test at 30° of knee flexion but negative at 90°. This finding is MOST consistent with injury to:

Answer: Posterolateral corner structures only

Increased external tibial rotation at 30° but not at 90° isolates injury to the posterolateral corner (PLC) structures without PCL involvement.

During lumbar spine assessment, which finding is considered a 'red flag' requiring urgent medical referral?

Answer: Saddle anesthesia with bowel/bladder dysfunction

Saddle anesthesia combined with bowel or bladder dysfunction suggests cauda equina syndrome, a surgical emergency requiring immediate referral.

A clinician applies a valgus stress at 30° of knee flexion and detects medial joint gapping without a firm endpoint. This finding indicates:

Answer: Complete MCL rupture

Valgus stress at 30° isolates the MCL; gapping without a firm endpoint indicates complete (Grade III) MCL rupture.

Which cluster of tests has the highest diagnostic accuracy for identifying lumbar spinal stenosis?

Answer: Bilateral neurogenic claudication, relief with flexion, and wide-based gait

Neurogenic claudication relieved by lumbar flexion (shopping cart sign) combined with wide-based gait forms a high-accuracy cluster for lumbar spinal stenosis.

A patient with shoulder pain has a positive internal rotation resistance strength test (IRRST). This finding suggests:

Answer: Internal impingement with posterior rotator cuff pathology

IRRST assesses internal impingement; weakness or pain with resisted IR at 90° ABD and ER suggests posterior rotator cuff pathology from internal impingement.

The Ottawa Ankle Rules indicate radiographic examination is needed when a patient has bony tenderness at the:

Answer: Posterior edge of the lateral malleolus or base of 5th metatarsal

Ottawa Ankle Rules recommend X-ray when there is bony tenderness at the posterior distal fibula/tibia, base of 5th metatarsal, or navicular, plus inability to weight-bear.

During a hip examination, a positive FADDIR test (Flexion, ADDuction, Internal Rotation) is MOST associated with:

Answer: Femoroacetabular impingement

FADDIR (anterior impingement test) compresses the femoral head-neck junction against the acetabular rim, reproducing pain in femoroacetabular impingement.