OCS Orthopedic Assessment & Diagnosis 2 — Questions and Answers
Question 1: A patient presents with lateral elbow pain that worsens with resisted wrist extension and gripping. Which provocative test is MOST specific for lateral epicondylalgia?
- Cozen's test (Correct answer)
- Valgus stress test
- Tinel's sign at the elbow
- Golfer's elbow test
Correct answer: Cozen's test
Cozen's test (resisted wrist extension with elbow extended) provokes pain at the lateral epicondyle and is highly specific for lateral epicondylalgia.
Question 2: During a lumbar spine assessment, a patient has a positive slump test that is relieved by cervical extension. What does this finding indicate?
- Neural tissue mechanosensitivity (Correct answer)
- Lumbar facet joint pathology
- Piriformis syndrome
- Hip flexor tightness
Correct answer: Neural tissue mechanosensitivity
Relief of symptoms with cervical extension during the slump test confirms neural tissue mechanosensitivity, implicating the neuromeningeal structures.
Question 3: Which special test assesses the integrity of the transverse carpal ligament and median nerve compression at the wrist?
- Phalen's test (Correct answer)
- Allen's test
- Finkelstein's test
- Watson's test
Correct answer: Phalen's test
Phalen's test (sustained wrist flexion) increases carpal tunnel pressure and reproduces median nerve symptoms in carpal tunnel syndrome.
Question 4: A 55-year-old presents with insidious onset of shoulder pain and progressive loss of glenohumeral motion equally in all planes. The MOST likely diagnosis is:
- Adhesive capsulitis (Correct answer)
- Rotator cuff tear
- Subacromial impingement
- Acromioclavicular joint arthritis
Correct answer: Adhesive capsulitis
Global loss of glenohumeral motion (capsular pattern: ER > ABD > IR) in a progressive insidious presentation is pathognomonic for adhesive capsulitis.
Question 5: When assessing for a posterior cruciate ligament tear, the clinician should perform which test?
- Posterior drawer test (Correct answer)
- Lachman's test
- Pivot shift test
- McMurray's test
Correct answer: Posterior drawer test
The posterior drawer test evaluates posterior tibial translation and is the primary clinical test for posterior cruciate ligament integrity.
Question 6: A patient exhibits a Trendelenburg gait pattern during single-leg stance on the right. Which structure is MOST likely dysfunctional?
- Right hip abductors (Correct answer)
- Left hip abductors
- Right hip flexors
- Left quadriceps
Correct answer: Right hip abductors
A Trendelenburg sign occurs ipsilaterally when the stance-side hip abductors (right) are weak, causing the pelvis to drop on the contralateral side.
Question 7: Which of the following best describes the McKenzie classification of 'derangement syndrome' in lumbar assessment?
- Pain that centralizes with repeated movements in one direction (Correct answer)
- Pain that is constant and unaffected by movement
- Pain that worsens with all lumbar movements equally
- Pain reproduced only with palpation
Correct answer: Pain that centralizes with repeated movements in one direction
Derangement syndrome is characterized by centralization of symptoms with repeated end-range loading in a specific direction, guiding directional preference treatment.
OCS Orthopedic Assessment & Diagnosis 2
A patient presents with lateral elbow pain that worsens with resisted wrist extension and gripping.
Which provocative test is MOST specific for lateral epicondylalgia?