SCS Clinical Examination & Diagnosis 3 — Questions and Answers
Question 1: A soccer player has a positive FABER test with groin pain reproduction. Which structure is LEAST likely to be the pain generator identified by this test?
- Sacroiliac joint
- Hip joint (anterior labrum)
- Iliopsoas tendon
- Lumbar facet joint (Correct answer)
Correct answer: Lumbar facet joint
FABER (flexion, abduction, external rotation) stresses the anterior hip joint, SI joint, and iliopsoas, but does not significantly load the lumbar facet joints.
Question 2: The O'Brien active compression test is performed with the arm at 90° forward flexion, 15° adduction, and internal rotation. A positive result (pain relief with supination) indicates pathology at which location?
- Infraspinatus insertion
- Posterior capsule
- AC joint or superior labrum (SLAP) (Correct answer)
- Subscapularis tendon
Correct answer: AC joint or superior labrum (SLAP)
A positive O'Brien test (pain in IR reduced or eliminated in ER) implicates the AC joint or superior labrum (SLAP lesion) depending on pain location.
Question 3: An overhead athlete demonstrates a GIRD (glenohumeral internal rotation deficit) of 25° compared to the contralateral side. What is the clinical threshold for GIRD that warrants intervention?
- 5°
- 10°
- 18° (Correct answer)
- 25°
Correct answer: 18°
A GIRD of ≥18° compared to the contralateral side is the commonly cited threshold associated with increased injury risk and warranting posterior capsule stretching intervention.
Question 4: Which provocative test is most appropriate for identifying a snapping iliopsoas tendon (coxa saltans interna) in a ballet dancer?
- Ober test with repeated hip extension
- Active hip flexion to extension arc in slight abduction (Correct answer)
- Resisted hip external rotation in seated position
- Hip scour test in figure-four position
Correct answer: Active hip flexion to extension arc in slight abduction
Actively moving from hip flexion to extension in slight abduction and external rotation reproduces the snap as the iliopsoas tendon flicks over the iliopectineal eminence.
Question 5: A tennis player complains of medial elbow pain. Resisted wrist flexion and forearm pronation reproduce pain at the medial epicondyle. Which diagnosis is MOST consistent?
- Ulnar collateral ligament sprain
- Medial epicondylitis (golfer's elbow) (Correct answer)
- Cubital tunnel syndrome
- Pronator teres syndrome
Correct answer: Medial epicondylitis (golfer's elbow)
Medial epicondylitis (golfer's elbow) involves the flexor-pronator mass origin and is reproduced by resisted wrist flexion and pronation at the medial epicondyle.
Question 6: During the lumbar spine examination of a gymnast, which finding during the single-leg stance extension (stork) test is most specific for spondylolysis?
- Ipsilateral posterior thigh pain
- Ipsilateral low back pain at the lumbosacral junction (Correct answer)
- Bilateral paraspinal muscle spasm
- Contralateral hip flexor tightness
Correct answer: Ipsilateral low back pain at the lumbosacral junction
Ipsilateral low back pain at the lumbosacral region during single-leg stance extension (stork test) is the hallmark finding for spondylolysis at the pars interarticularis.
Question 7: A softball pitcher presents with valgus elbow instability. The moving valgus stress test is positive. At which arc of elbow motion is the UCL maximally stressed during this test?
- 0–30° flexion
- 30–60° flexion
- 70–120° flexion (Correct answer)
- 120–135° flexion
Correct answer: 70–120° flexion
The UCL is maximally stressed between 70° and 120° of elbow flexion during the moving valgus stress test, corresponding to the late cocking through acceleration phase of throwing.
SCS Clinical Examination & Diagnosis 3
A soccer player has a positive FABER test with groin pain reproduction.
Which structure is LEAST likely to be the pain generator identified by this test?