Clinical Assessment and Treatment of the Knee, Lumbar Spine, and Shoulder

A comprehensive set of vocabulary flashcards covering clinical presentations, objective orthopedic tests (with specificity and sensitivity stats), and rehabilitation treatments for the knee, lumbar spine, and shoulder based on the lecture transcript.

Valgus vs. Varus

Anterior knee observation measures; valgus refers to knock-kneed alignment, while varus refers to bow-legged alignment.

Antalgic gait

A gait pattern characterized by a shortened stride length on the affected side, often indicating pain as the patient attempts to reduce weight-bearing on that limb.

Patellar tendonopathy

A condition presenting with pain triggered by overload ($jumping$, $hopping$, $sprinting$), tenderness upon palpation of the patellar tendon, and worsening symptoms during resisted quadriceps testing.

Patella Apprehension test

A test for patella instability ($Specificity 88.4\%$, $Sensitivity 100\%$) performed with the patient supine and knee flexed at $300$. A positive result is patient apprehension or excessive movement during a passive lateral patella glide.

Anterior Draw Test

An objective measure for ACL injury ($Specificity 91\%$, $Sensitivity 92\%$) performed with the knee bent to $900$ and hips at $4g0$. A positive test shows tibia translation $>S-Omm$ with a soft, mushy endpoint.

PCL sag sign

An assessment for PCL injury ($Sp 85-100\%$, $Se 79-90\%$) where the patient lies flat with the knee at $900$; a positive result occurs if the tibia visibly sags backwards.

Varus Stress test

A test for LCL injury ($sensitivity 25\%$) where lateral stress is applied to the knee at $00$ and $200$ flexion while stabilizing the ankle to look for gapping on the lateral aspect.

Valgus stress test

An objective measure for MCL injuries with a $Specificity$ of $49\%$ and a $Sensitivity$ of $91\%$ to detect joint laxity.

Meniscus Injury Presentation

Clinical signs including trauma or degenerative wear, joint line pain, reduced ROM, and potential locking, specifically in cases of a bucket handle tear.

Lumbar Reflex testing

The clinical assessment of neurological levels where the Patella reflex corresponds to $L4$ and the Achilles tendon reflex corresponds to $Sl$.

Hyperlordosis vs. Hypolordosis

Lumbar spine curvatures where hyperlordosis (exaggerated curve) suggests facet pathology and hypolordosis (flattened curve) suggests discogenic pain or disc herniation.

Lateral Shift

A posterior spinal alignment observation where the spine shifts to the side, frequently serving as a sign of disc herniation.

Mechanical LBP

Dull or sharp localized ache at the $14-15$ region triggered by muscle strain or posture; it usually loosens with activity and has localized pain during the Lumbar Quadrant test.

Lumbar Quadrant test

A standing objective measure for facet-driven mechanical pain ($Specificity 67\%$, $Sensitivity 50-70\%$) involving spine extension, side flexion, and rotation towards the test side.

Slump test

A neurodynamic test for lumbar disc herniation ($Specificity 83\%$, $Sensitivity 91\%$) involving slumping, neck flexion, and knee extension to reproduce radicular symptoms.

FAIR test

A diagnostic test for Piriformis syndrome ($Specificity 83\%$, $Sensitivity 88\%$) involving flexion, adduction, and internal rotation to compress the sciatic nerve under the piriformis.

Thigh thrust test

An objective measure for Sacroiliac joint (SIJ) dysfunction with a $Specificity$ of $89\%$ and a $Sensitivity$ of $88\%$.

Adhesive capsulitis

Also known as frozen shoulder; a three-phase condition characterized by progressive pain and reduced ROM ($2-9$ months), increased stiffness ($4-12$ months), and eventual recovery ($5-12$ months).

Isometric external rotation

A Treatment 1 for Rotator cuff tendinopathy where the arm is pushed outward against a wall to activate the rotator cuff and reduce pain sensitivity in early-stage loading.

Glenohumeral Joint MET

A Muscle Energy Technique for adhesive capsulitis where a patient in supine matches $20\%$ resistance against a barrier in internal and external rotation.

Serratus anterior wall slides

A treatment for Postural Shoulder destruction where the patient slides forearms up a wall and protracts at end range to target the serratus anterior and lower traps.

Wand flexion overhead

A Treatment 1 for long head of biceps tendinopathy where a bar is raised in supine to allow the non-injured shoulder to assist the injured one.

Closed chain ball against wall

A Treatment 1 for AC joint irritation where the patient applies the heel of the hand into a ball and moves in circles, up, down, or diagonally for $30-60$ seconds.

Shoulder supported pendular exercise

A Treatment 1 for post-anterior shoulder dislocation where the affected arm is supported by the unaffected arm to allow for safe passive ROM and improved blood flow.