Pivot-shift test

Pivot-shift test is a physical examination procedure, primarily used by medical professionals to assess the stability of the anterior cruciate ligament (ACL) in the knee. This test is often performed when a patient presents with knee pain or injury, and the healthcare provider suspects an ACL tear or other knee pathology.

Procedure

The pivot-shift test is performed with the patient lying supine on the examination table. The examiner holds the patient's heel with one hand and the knee with the other. The knee is then flexed to 30 degrees while a valgus force is applied to the knee and an axial load is applied to the foot. The knee is then slowly extended. A positive test is indicated by a sudden "shift" or "jerk" at approximately 20-40 degrees of knee flexion.

Interpretation

A positive pivot-shift test suggests an injury to the anterior cruciate ligament. However, it's important to note that this test is not 100% accurate and further diagnostic tests such as an MRI may be required to confirm the diagnosis.

Limitations

The pivot-shift test has several limitations. It is a complex maneuver that requires practice to perform accurately. Additionally, the test may be difficult to perform if the patient has significant pain or muscle guarding. Finally, the sensitivity and specificity of the pivot-shift test can vary depending on the examiner's experience and the patient's condition.

See also

• Anterior cruciate ligament
• Knee examination
• MRI

References

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