Athletic Training & Sports Medicine Center

  

Examination Links:

  • Alphabetical Listing
of Examinations
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 - upper limb
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 - lower limb
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 Test
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    • Sagittal Plane ROM Test
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 Test
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Stability Test
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(Horizontal Adduction) Test
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 Stress Test
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Test
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Compression Test
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 Test
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 Test
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Ligament Stress Test
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Ligament Stress Test
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Ligament Stress Test
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Ligament Stress Test
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Ligament Stress Test
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Ligament Stress Test
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of Hip
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      Sacroiliac Rocking Test
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Drawer Test
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    • Pivot Shift Test
    • External Rotation 
Recurvatum Test
    •  
  • Lower Leg
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  • Foot
    • Morton Test
    •  
  • Range of Motion
  • Goniometry
  • Manual Muscle Testing
  • Reflexes
  • Vital Signs
  • Body Composition

 

Pivot Shift Test – Lateral Pivot Shift Maneuver Test of Machintosh – Pivot-Jerk Test

Examination type Ligamentous Stability
Patient & Body Segment Positioning Patient should lie supine, and be completely relaxed on the exam table
Examiner Position The examiner will grasp the patient’s ankle with one hand, and also grasp the lateral side of the leg level with the fibular head.
Tissues Being Tested Anterior Cruciate Ligament
Performing the Test Examiner will passively move the patient’s hip into 30 degrees of abduction and flexion. The examiner will then medially rotate the leg slightly. Next, the examiner will axial load the leg and flex the knee with the lower hand while applying valgus stress to the knee with the upper hand. Once the subluxation is felt the examiner will then extend the leg 30 – 40 degrees to reduce the subluxation.
Positive Test

If an anterolateral subluxation of the tibia occurs along with a reduction of the lateral femoral condyle the test is positive.
Interpretation

 Anterolateral Rotary Instability; ACL Sprain or Tear
Common errors in performing exam Possible errors in performing this test can include but are not limited to: improper patient positioning, improper examiner positioning, having active participation from the patient, and not allowing the patient to fully relax before and during the examination.
Factors possibly resulting in misinterpretation Several factors can cause the examiner to read a false negative for this test. If the IT Band is sprained or torn or if excessive swelling is present, the examiner may have a false negative test. Also, if the patient is apprehensive, the protective muscle contractions produced will cause a false negative by not allowing the tibia to slip backwards.
Related tests Soft Pivot Shift Test; Active Pivot Shift Test; Jerk Test of Hughston; Losee Test; Slocum ALRI Test; Crossover Test of Arnold; Noyes Flexion-Rotation Drawer Test; Lemaire’s Jolt Test; Flexion-Extension Valgus Test; Nakajima Test; Marten’s Test
References

 Booher, James M., & Thibodeau Gary A. (2000). Athletic Injury Assessment Fourth Edition. U.S.A.: McGraw-Hill.

Magee, David J. (2002). Orthopedic Physical Assessment. Philadelphia, PA: Elsevier.

Prentice, William E. (2003). Arnheim’s Principles of Athletic Training A Competency-Based Approach. U.S.A.: McGraw-Hill Companies, INC. 
Links:

http://www.sportsdoc.umn.edu/Clinical_Folder/Knee_Folder/Knee_Exam/pivot%20shift.htm

http://www.wheelessonline.com/ortho/pivot_shift_test

http://www.mmsfitness.com/steroid_newsletter/kneeinjury/acute_knee_injuries.htm

http://www.mayoclinic.com/health/acl-injury/AC99999/PAGE=AC00005

http://www.geocities.com/schach23/ACL/ACLtear.html?200622

 

 
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