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Yergason's Test

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Yergason's Test is a special test used for orthopedic examination of the shoulder, specifically the biceps tendon [1] It tests for two specific positive findings: pain in the bicipital groove indicating biceps tendinitis [2][3], and subluxation of the long head of the biceps brachii muscle.[4]

Procedure

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To perform the test, the examiner must stand on the affected side of the patient. The patient needs to be in a seated position with the elbow flexed to 90°, forearm pronated (palm facing the ground), and stabilized against the thorax.[5][6] The examiner places the stabilizing hand on the proximal portion of the humerus near the bicipital groove, and the resistance hand on the distal forearm and wrist.[7][8]

  • The patient is instructed to actively supinate the forearm, externally rotate the humerus, and flex the elbow against the resistance of the examiner.[9][10] Referred pain by the patient results in one of the previous mentioned positive signs.
  • Difficult test to perform for accurate diagnosis.[11]
  • Biceps tendonitis can be usually be accurately addressed by palpating the long head of the biceps tendon in the bicipital groove.[12]

References

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  1. ^ Thomas W. Woodward, Thomas M. Best. "The Painful Shoulder: Part 1. Clinical Evaluation." American Family Physicians. Ed. William E. Schekler. 1 May 2000. 9 March 2011. <http://www.aafp.org/afp/20000515/3079.html>.
  2. ^ Jeff G. Konin et al. Special Tests for Orthopedic Examination: Third Edition. Thorofare, NJ. SLACK Incorporated, 2006.
  3. ^ W. Ben Kibler, Aaron D. Sciascia, Peter Hester, David Dome, and Cale Jacobs. "Critical Utility of Traditional and New Tests in the Diagnosis of New Bicep Tendon Injuries in Superior Labrum Anterior and Posterior Lesions in the Shoulder." Am J Sports Med. 37 (2009): 1840-1847.
  4. ^ W. Ben Kibler, Aaron D. Sciascia, Peter Hester, David Dome, and Cale Jacobs. "Critical Utility of Traditional and New Tests in the Diagnosis of New Bicep Tendon Injuries in Superior Labrum Anterior and Posterior Lesions in the Shoulder." Am J Sports Med. 37 (2009): 1840-1847.
  5. ^ Jeff G. Konin et al. Special Tests for Orthopedic Examination: Third Edition. Thorofare, NJ. SLACK Incorporated, 2006.
  6. ^ W. Ben Kibler, Aaron D. Sciascia, Peter Hester, David Dome, and Cale Jacobs. "Critical Utility of Traditional and New Tests in the Diagnosis of New Bicep Tendon Injuries in Superior Labrum Anterior and Posterior Lesions in the Shoulder." Am J Sports Med. 37 (2009): 1840-1847.
  7. ^ Jeff G. Konin et al. Special Tests for Orthopedic Examination: Third Edition. Thorofare, NJ. SLACK Incorporated, 2006.
  8. ^ Thomas W. Woodward, Thomas M. Best. "The Painful Shoulder: Part 1. Clinical Evaluation." American Family Physicians. Ed. William E. Schekler. 1 May 2000. 9 March 2011. <http://www.aafp.org/afp/20000515/3079.html>.
  9. ^ Jeff G. Konin et al. Special Tests for Orthopedic Examination: Third Edition. Thorofare, NJ. SLACK Incorporated, 2006.
  10. ^ Thomas W. Woodward, Thomas M. Best. "The Painful Shoulder: Part 1. Clinical Evaluation." American Family Physicians. Ed. William E. Schekler. 1 May 2000. 9 March 2011. <http://www.aafp.org/afp/20000515/3079.html>.
  11. ^ Jeff G. Konin et al. Special Tests for Orthopedic Examination: Third Edition. Thorofare, NJ. SLACK Incorporated, 2006.
  12. ^ Jeff G. Konin et al. Special Tests for Orthopedic Examination: Third Edition. Thorofare, NJ. SLACK Incorporated, 2006.


Kernig-Brudzinski Signs/Test

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The Kernig-Brudzinski Test is an orthopedic special test concerning the lumbar and thoracic portion of the spine, specifically testing for meningitis.[1] It contains a combination of sequential passive and active flexing movements of various body parts: the head (Brudzinski's Sign), and the hip and knees (Kernig's Sign). Increased pain is the confirmed positive finding and is indicative of other pathologies: nerve root impingement caused by intervertebral disk bulging, bony entrapment[2] or narrowing of the intervertebral foramen[3], and exaggerated dural sheath irritation/tension with elongation of the spinal cord (Brudzinski's Sign).[4]

Procedure

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  • Kernig's Sign
Patient performs unilateral straight leg raise (SLR) on examiner side until pain occurs with knee in full extension.[5]
Patient actively flexes hip and knee to no more than 90°, while leaving opposite leg on examining table.[6]
Positive sign: Radiating pain into lower extremities or localized pain in spine, while knee flexion relieves the pain.[7][8]
  • Brudzinksi's Sign
Passive cervical spine flexion (lifting head upward) accompanied by hip and knee flexion.
Performed due to an absence of pain during the SLR.[9]

Eponym

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  • Kernig's Sign: It was named after Vladimir Kernig.
  • Brudzinski's Sign: It was named after Josef Brudzinski.

References

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  1. ^ Jeff G. Konin et al. Special Tests for Orthopedic Examination: Third Edition. Thorofare, NJ. SLACK Incorporated, 2006.
  2. ^ Chad Starkey, Sara D. Brown, and Jeff Ryan. Orthopedic and Athletic Injury Examination Handbook: Edition 2. Philadelphia: F.A. Davis Company, 2010.
  3. ^ Asif Sabiri, Saeed A. Syed. "Meningeal Signs:kernig's Sign and Brudzinski's Sign." Hospital Physician. July 1999. 9 March 2011. <http://www.turner-white.com/pdf/hp_jul99_signs.pdf>
  4. ^ Jeff G. Konin et al. Special Tests for Orthopedic Examination: Third Edition. Thorofare, NJ. SLACK Incorporated, 2006.
  5. ^ Chad Starkey, Sara D. Brown, and Jeff Ryan. Orthopedic and Athletic Injury Examination Handbook: Edition 2. Philadelphia: F.A. Davis Company, 2010.
  6. ^ Jeff G. Konin et al. Special Tests for Orthopedic Examination: Third Edition. Thorofare, NJ. SLACK Incorporated, 2006.
  7. ^ Jeff G. Konin et al. Special Tests for Orthopedic Examination: Third Edition. Thorofare, NJ. SLACK Incorporated, 2006.
  8. ^ Chad Starkey, Sara D. Brown, and Jeff Ryan. Orthopedic and Athletic Injury Examination Handbook: Edition 2. Philadelphia: F.A. Davis Company, 2010.
  9. ^ Chad Starkey, Sara D. Brown, and Jeff Ryan. Orthopedic and Athletic Injury Examination Handbook: Edition 2. Philadelphia: F.A. Davis Company, 2010.


Froment's Sign: enhanced existing article. http://en.wikipedia.org/wiki/Froment%27s_sign

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