OCS Orthopedic Assessment & Diagnosis 3 — Questions and Answers
Question 1: A patient has a positive Ober's test with limited hip adduction in sidelying. This finding suggests tightness of which structure?
- Iliotibial band and tensor fasciae latae (Correct answer)
- Hip adductor group
- Piriformis muscle
- Gluteus maximus
Correct answer: Iliotibial band and tensor fasciae latae
Ober's test assesses iliotibial band and tensor fasciae latae flexibility; limited hip adduction in the test position indicates tightness of these structures.
Question 2: During cervical assessment, a patient's radicular symptoms are reproduced by ipsilateral lateral flexion and rotation with axial compression. This describes:
- Spurling's test (Correct answer)
- Distraction test
- Valsalva maneuver
- Sharp-Purser test
Correct answer: Spurling's test
Spurling's test (cervical compression with ipsilateral lateral flexion and rotation) narrows the neural foramen and reproduces cervical radiculopathy symptoms.
Question 3: A 30-year-old soccer player reports medial knee pain with joint line tenderness and pain during McMurray's test with valgus stress and external rotation. The MOST likely diagnosis is:
- Medial meniscus tear (Correct answer)
- MCL sprain
- ACL tear
- Pes anserine bursitis
Correct answer: Medial meniscus tear
McMurray's test with valgus stress and external tibial rotation specifically loads the medial meniscus, and a positive test with joint line pain indicates a medial meniscus tear.
Question 4: Which reflex, if absent, is MOST consistent with an L4 nerve root lesion?
- Patellar reflex (Correct answer)
- Achilles reflex
- Medial hamstring reflex
- Posterior tibial reflex
Correct answer: Patellar reflex
The patellar (knee jerk) reflex is primarily mediated by the L4 nerve root, and its absence suggests L4 radiculopathy.
Question 5: The FABER test (Flexion, ABduction, External Rotation) is used to assess which structures?
- Hip joint and sacroiliac joint (Correct answer)
- Lumbar facet joints and discs
- Knee ligaments and menisci
- Ankle mortise and syndesmosis
Correct answer: Hip joint and sacroiliac joint
FABER test stresses both the hip joint (anterior capsule, labrum) and the sacroiliac joint, making it a useful screen for both pathologies.
Question 6: A patient presents with forearm pain and a positive Finkelstein's test. Which diagnosis is MOST consistent?
- De Quervain's tenosynovitis (Correct answer)
- Carpal tunnel syndrome
- Lateral epicondylalgia
- Ulnar nerve entrapment
Correct answer: De Quervain's tenosynovitis
Finkelstein's test (ulnar deviation with thumb in fist) stretches the first dorsal compartment tendons (APL and EPB) and is pathognomonic for De Quervain's tenosynovitis.
Question 7: When evaluating shoulder impingement, which test specifically implicates the supraspinatus tendon by positioning the arm at 90° forward flexion with internal rotation?
- Hawkins-Kennedy test (Correct answer)
- Neer impingement test
- Empty can test
- Drop arm test
Correct answer: Hawkins-Kennedy test
The Hawkins-Kennedy test (arm at 90° flexion, internally rotated) impinges the supraspinatus under the coracoacromial ligament, reproducing subacromial impingement symptoms.
OCS Orthopedic Assessment & Diagnosis 3
A patient has a positive Ober's test with limited hip adduction in sidelying.
This finding suggests tightness of which structure?