Mnemonic

Shoulder and Knee Special Tests

A memory aid for the named special tests of the shoulder and knee.

Expansion

Impingement and cuff tests at the shoulder; ligament and meniscal tests at the knee

Expansion

Shoulder

  • Empty can (Jobe) test: supraspinatus
  • Resisted external rotation: infraspinatus and teres minor
  • Gerber lift-off: subscapularis
  • Neer and Hawkins-Kennedy: subacromial impingement
  • Apprehension test: anterior instability
  • Scarf test: acromioclavicular joint

Knee

  • Lachman test: anterior cruciate ligament; the most sensitive
  • Anterior and posterior drawer: cruciate ligaments
  • Valgus and varus stress: medial and lateral collateral ligaments, tested at 0 and 30 degrees
  • McMurray test: meniscal tears
  • Patellar tap and bulge sign: effusion
  • Patellar apprehension: instability

Hip: Thomas test for fixed flexion deformity, Trendelenburg for abductor weakness.

Two general points. Special tests are most useful when combined, since individually most have modest sensitivity or specificity. And they should always follow, not replace, a careful look, feel, move examination, since the diagnosis is usually apparent before any special test is performed.