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For study and OSCE preparation only — not a substitute for clinical judgement or a full examination.
Created byMahmoud Elshorbagy
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Anterior Apprehension Test
Evaluates for anterior glenohumeral instability.
Positive Sign
Apprehension (fear of dislocation) as the shoulder is externally rotated in abduction. Clinical Pearl
Apprehension — not pain — is the defining positive. If pain relieves with the Relocation test, instability is more likely than primary impingement. Differential Diagnosis
Bankart lesion, SLAP tear, rotator cuff pathology, generalized laxity.Region: Shoulder
Ligament
Anterior Drawer Test
Assesses the integrity of the ACL with the knee flexed to 90 degrees.
Positive Sign
Increased anterior translation of the tibia relative to the uninjured side with a diminished end-feel. Clinical Pearl
Always inspect for a posterior tibial sag before you start — otherwise a PCL tear masquerades as a positive anterior drawer. Differential Diagnosis
PCL tear (a posterior sag gives a false-positive anterior excursion), meniscal injury, hamstring guarding.Region: Knee
Ligament
Anterior Drawer Test (Ankle)
Assesses the integrity of the anterior talofibular ligament (ATFL) — the most commonly injured lateral ankle ligament.
Positive Sign
Increased anterior translation of the talus (with or without a dimple/suction sign) compared with the uninjured ankle. Clinical Pearl
Clear a fracture first using the Ottawa Ankle Rules, and retest at 4-5 days — the anterior drawer is far more reliable once acute guarding has resolved. Differential Diagnosis
Calcaneofibular ligament injury, syndesmotic (high ankle) sprain, osteochondral lesion, fracture (apply Ottawa rules).Region: Ankle
Radiculopathy
Cervical Distraction Test
A relieving test for cervical radiculopathy caused by foraminal compression.
Positive Sign
Reduction or relief of the patient’s radicular arm symptoms with distraction. Clinical Pearl
This is one of the few tests where symptom RELIEF is the positive finding — it points to a foraminal/compressive source that traction unloads. Differential Diagnosis
Facet-mediated pain, muscular pain, shoulder pathology.Region: Cervical
Tendinopathy
Cozen's Test
Evaluates for lateral epicondylalgia (tennis elbow).
Positive Sign
Pain reproduced over the lateral epicondyle / common extensor origin with resisted wrist extension. Clinical Pearl
If pain localizes ~4-5 cm distal to the epicondyle over the mobile wad, consider radial tunnel syndrome rather than tennis elbow. Differential Diagnosis
Radial tunnel syndrome, posterolateral rotatory instability, C6 radiculopathy, osteochondral lesion.Region: Elbow
Rotator Cuff
Drop Arm Test
Assesses for a full-thickness rotator cuff (especially supraspinatus) tear.
Positive Sign
The arm drops suddenly or the patient cannot lower it smoothly, often with a compensatory shrug. Clinical Pearl
A positive Drop Arm is uncommon but meaningful — because it is specific, it markedly raises suspicion for a complete tear. Differential Diagnosis
Partial cuff tear, subacromial impingement, axillary/suprascapular nerve injury, severe pain inhibition.Region: Shoulder
Rotator Cuff
Empty Can (Jobe) Test
Assesses the supraspinatus muscle and tendon.
Positive Sign
Weakness and/or pain reproduced during resisted downward pressure. Clinical Pearl
Distinguish pain from weakness: weakness (a positive strength component) is what raises concern for an actual tear. Differential Diagnosis
Subacromial impingement, supraspinatus tendinopathy vs full-thickness tear, suprascapular neuropathy.Region: Shoulder
Mobility
FABER (Patrick) Test
Screens for intra-articular hip pathology and sacroiliac (SI) joint dysfunction. FABER = Flexion, ABduction, External Rotation.
Positive Sign
Anterior groin pain suggests intra-articular hip pathology; posterior pain suggests the SI joint. Restricted range (knee remains high) also indicates hip involvement. Clinical Pearl
Localize the pain: anterior groin points to the hip joint, posterior points to the SI joint. Location is more informative than the pain alone. Differential Diagnosis
Femoroacetabular impingement, labral tear, hip osteoarthritis, SI joint dysfunction, iliopsoas pathology.Region: Hip
Impingement
FADIR Test
Screens for anterior femoroacetabular impingement (FAI) and anterosuperior labral tears. FADIR = Flexion, ADduction, Internal Rotation.
Positive Sign
Reproduction of the patient’s anterior groin pain (with or without a click). Clinical Pearl
Because it is sensitive but not specific, a negative FADIR is a good way to make intra-articular impingement unlikely. Differential Diagnosis
Labral tear, FAI (cam/pincer), iliopsoas tendinopathy, hip osteoarthritis.Region: Hip
Tendinopathy
Finkelstein Test
A provocative test for De Quervain’s tenosynovitis (first dorsal compartment: APL and EPB tendons).
Positive Sign
Sharp pain over the radial styloid / first dorsal compartment during ulnar deviation. Clinical Pearl
Differentiate from thumb CMC osteoarthritis (a common mimic) by localizing tenderness precisely to the first dorsal compartment over the radial styloid. Differential Diagnosis
Thumb carpometacarpal (CMC) osteoarthritis, scaphoid fracture, intersection syndrome, radial sensory nerve (Wartenberg) irritation.Region: Wrist
Tendinopathy
Golfer's Elbow Test (Medial Epicondyle)
Evaluates for medial epicondylalgia (golfer’s elbow).
Positive Sign
Pain reproduced over the medial epicondyle / common flexor-pronator origin. Clinical Pearl
Screen the ulnar nerve (Tinel at the cubital tunnel, intrinsic strength) — ulnar neuropathy commonly coexists with medial epicondylalgia. Differential Diagnosis
Ulnar collateral ligament injury, cubital tunnel (ulnar nerve) syndrome, C7 radiculopathy.Region: Elbow
Impingement
Hawkins-Kennedy Test
Screens for subacromial impingement, particularly of the supraspinatus.
Positive Sign
Reproduction of anterolateral shoulder pain with internal rotation. Clinical Pearl
Internal rotation drives the greater tuberosity under the coracoacromial arch, which is why it provokes subacromial impingement symptoms. Differential Diagnosis
Supraspinatus tendinopathy or tear, subacromial bursitis, biceps pathology.Region: Shoulder
Ligament
Lachman Test
Assesses the integrity of the anterior cruciate ligament (ACL). Considered the most accurate manual test for ACL insufficiency, especially in the acute setting.
Positive Sign
Increased anterior translation of the tibia compared with the uninjured side and a soft or absent (mushy) end-feel. Clinical Pearl
Grade by end-feel, not just distance. A firm end-feel with a few extra millimetres is far more reassuring than a soft/absent end-feel. Always compare sides. Differential Diagnosis
PCL tear (beware a false start from a posteriorly sagged tibia), generalized ligamentous laxity.Region: Knee
Meniscus
McMurray Test
Evaluates for tears of the medial and lateral menisci.
Positive Sign
A palpable or audible thud/click with pain reproduced along the corresponding joint line. Clinical Pearl
Because it is specific but insensitive, use McMurray to confirm a suspicion — not to screen. Pair it with joint-line tenderness and Thessaly for better yield. Differential Diagnosis
Chondral lesion, plica syndrome, loose body, degenerative joint disease.Region: Knee
Impingement
Neer's Test
Screens for subacromial (external) impingement of the rotator cuff.
Positive Sign
Reproduction of the patient’s anterolateral shoulder pain during the manoeuvre. Clinical Pearl
Neer and Hawkins-Kennedy are screening tests — combine several impingement tests (a cluster) before concluding. Differential Diagnosis
Rotator cuff tendinopathy or tear, biceps tendinopathy, AC joint pathology, adhesive capsulitis.Region: Shoulder
Mobility
Ober's Test
Assesses for iliotibial band (ITB) / tensor fasciae latae tightness.
Positive Sign
The leg remains abducted and does not adduct to (or below) the horizontal, indicating ITB/TFL tightness. Clinical Pearl
Keep the hip in slight extension throughout — if the hip drifts into flexion, the ITB slips anterior to the trochanter and the test falsely appears negative. Differential Diagnosis
ITB syndrome, greater trochanteric pain syndrome, gluteus medius pathology, hip abductor contracture.Region: Hip
Patella
Patellar Apprehension Test
Evaluates for patellofemoral instability or a history of lateral patellar dislocation.
Positive Sign
Apprehension, guarding quadriceps contraction, or a report that the patella feels like it will dislocate. Clinical Pearl
Genuine apprehension (the patient stops you) is the key finding — pain alone is not the same as instability. Differential Diagnosis
Patellofemoral pain syndrome, medial patellofemoral ligament (MPFL) injury, chondromalacia patellae.Region: Knee
Nerve
Phalen's Test
A provocative test for carpal tunnel syndrome (median nerve compression at the wrist).
Positive Sign
Numbness/tingling in the median nerve distribution (thumb, index, middle, and radial half of the ring finger) within 60 seconds. Clinical Pearl
Symptoms must follow the MEDIAN distribution. Little-finger involvement points to the ulnar nerve or a more proximal cause, not the carpal tunnel. Differential Diagnosis
Cervical radiculopathy (C6-C7), pronator teres syndrome, thoracic outlet syndrome, peripheral neuropathy.Region: Wrist
Ligament
Posterior Drawer Test
Assesses the integrity of the posterior cruciate ligament (PCL).
Positive Sign
Increased posterior translation of the tibia relative to the uninjured side. Clinical Pearl
The posterior sag sign seen on inspection is often the earliest and clearest clue to a PCL injury. Differential Diagnosis
ACL injury (rule out with Lachman), posterolateral corner injury.Region: Knee
Neural Tension
Slump Test
A seated neural tension test for lumbar disc-related radiculopathy and adverse neural tension.
Positive Sign
Reproduction of radicular/neural symptoms that are relieved when cervical flexion is released. Clinical Pearl
The structural differentiation step (releasing neck flexion) is what distinguishes true neural tension from simple hamstring tightness. Differential Diagnosis
Hamstring tightness, lumbar disc herniation, neural adhesions, central sensitization.Region: Spine
Tendinopathy
Speed's Test
Assesses for biceps long-head tendinopathy or superior labral pathology.
Positive Sign
Pain reproduced in the bicipital groove (anterior shoulder) during resisted flexion. Clinical Pearl
Speed’s is sensitive but not specific — combine with Yergason’s and a labral test rather than using it alone. Differential Diagnosis
Subacromial impingement, SLAP lesion, rotator cuff pathology, AC joint pain.Region: Shoulder
Radiculopathy
Spurling's Test
A provocative test for cervical radiculopathy (nerve root compression).
Positive Sign
Reproduction of radicular pain/paraesthesia radiating into the ipsilateral arm (not just local neck pain). Clinical Pearl
Because it is specific but insensitive, a negative Spurling does not exclude radiculopathy — pair it with the ULTT (sensitive) and distraction tests as a cluster. Differential Diagnosis
Facet joint pain, myofascial referral, thoracic outlet syndrome, peripheral nerve entrapment, shoulder pathology.Region: Cervical
Neural Tension
Straight Leg Raise (SLR)
A neural tension test for lumbar disc herniation and L4-S1 radiculopathy.
Positive Sign
Reproduction of radicular pain radiating BELOW the knee (not merely hamstring tightness) between roughly 30 and 70 degrees. Clinical Pearl
A crossed SLR (raising the UNaffected leg reproduces symptoms on the affected side) is far more specific for disc herniation. Differential Diagnosis
Hamstring tightness, SI joint dysfunction, piriformis syndrome, central canal stenosis.Region: Spine
Ligament
Talar Tilt Test
Assesses the calcaneofibular ligament (CFL) and lateral ankle stability via inversion stress.
Positive Sign
Increased inversion talar tilt or pain compared with the uninjured side. Clinical Pearl
The CFL crosses both the talocrural and subtalar joints, so an isolated interpretation is difficult — combine talar tilt with the anterior drawer. Differential Diagnosis
ATFL injury, subtalar instability, peroneal tendon pathology, osteochondral lesion.Region: Ankle
Meniscus
Thessaly Test
A weight-bearing, dynamic test for meniscal tears — often more sensitive than McMurray.
Positive Sign
Medial or lateral joint-line discomfort, or a sense of locking/catching, during rotation at 20 degrees of flexion. Clinical Pearl
Being weight-bearing and dynamic, Thessaly reproduces functional meniscal loading — a useful complement to non-weight-bearing tests like McMurray. Differential Diagnosis
Chondral lesion, ligamentous injury, patellofemoral pain, loose body.Region: Knee
Mobility
Thomas Test
Assesses for a hip flexor (iliopsoas / rectus femoris) contracture.
Positive Sign
The lowered thigh remains off the table (hip stays flexed), indicating iliopsoas tightness; if the knee extends, rectus femoris is tight. Clinical Pearl
Watch the knee: if the thigh lifts AND the knee extends, the rectus femoris (a two-joint muscle) is the tight structure. Differential Diagnosis
Rectus femoris vs iliopsoas tightness, hip flexion contracture, anterior hip pathology.Region: Hip
Tendon
Thompson Test
Assesses for a complete Achilles tendon rupture.
Positive Sign
ABSENCE of passive plantarflexion when the calf is squeezed indicates a complete Achilles rupture. Clinical Pearl
A positive test is the ABSENCE of movement — the intact tendon normally transmits the calf squeeze into plantarflexion, so no movement means the tendon is discontinuous. Differential Diagnosis
Partial Achilles tear, gastrocnemius (calf) strain, ankle sprain, posterior tibial tendon pathology.Region: Ankle
Nerve
Tinel's Sign (Wrist)
A provocative test for carpal tunnel syndrome by tapping over the median nerve.
Positive Sign
Tingling or an electric sensation radiating into the median nerve distribution of the hand. Clinical Pearl
Tinel’s and Phalen’s are complementary — using them together (and with symptom history) improves the overall diagnostic picture more than either alone. Differential Diagnosis
Cervical radiculopathy, pronator teres syndrome, wrist ganglion, peripheral neuropathy.Region: Wrist
Muscle Strength
Trendelenburg Test
Assesses hip abductor (gluteus medius/minimus) strength and stability.
Positive Sign
The pelvis drops on the side of the LIFTED leg, indicating weakness of the abductors on the STANCE (weight-bearing) side. Clinical Pearl
Remember: the pelvis falls AWAY from the weak side. A drop on the left when standing on the right means right abductor weakness. Differential Diagnosis
Superior gluteal nerve palsy, hip osteoarthritis, developmental dysplasia, L5 radiculopathy, pain inhibition.Region: Hip
Neural Tension
Upper Limb Tension Test (Median)
A neural tension (neurodynamic) test that biases the median nerve; a sensitive screen for cervical radiculopathy.
Positive Sign
Reproduction of the patient’s arm symptoms, with side-to-side differences and symptom change on cervical side-flexion. Clinical Pearl
Confirm the response is neural by structural differentiation: a symptom change with cervical side-flexion (a movement far from the arm) implicates neural tissue. Differential Diagnosis
Peripheral median nerve entrapment (carpal/pronator), thoracic outlet syndrome, non-neural arm pain.Region: Cervical
Ligament
Valgus Stress Test
Assesses the integrity of the medial collateral ligament (MCL).
Positive Sign
Increased medial gapping/laxity or reproduction of pain at the medial joint line compared with the contralateral knee. Clinical Pearl
Laxity at 30 degrees = MCL. Laxity that persists in full extension signals additional cruciate or posteromedial corner injury. Differential Diagnosis
Medial meniscus injury, cruciate/capsular involvement (if lax in full extension), pes anserine pathology.Region: Knee
Ligament
Varus Stress Test
Assesses the integrity of the lateral collateral ligament (LCL) and posterolateral corner.
Positive Sign
Increased lateral gapping/laxity or lateral joint-line pain compared with the uninjured knee. Clinical Pearl
Isolated LCL tears are uncommon; lateral laxity should prompt a search for posterolateral corner and cruciate involvement. Differential Diagnosis
Posterolateral corner injury, lateral meniscus tear, common peroneal nerve involvement.Region: Knee