- Listener Questions12:13Paper Chase #1 | Diclofenac Is Associated With Increased Cardiovascular Risk5:18Mastitis19:39Vitamin Deficiencies In Alcoholics18:53Paper Chase #2 | Cephalosporins Are Best For Pyelonephritis4:34In Shock23:29What Would I Do Next? | Abdominal X-rays For Pediatric Constipation12:40Paper Chase #3 | Scan Minor Head Trauma On Anticoagulation3:53Acromioclavicular (AC) Joint & Sternoclavicular (SC) Joint InjuriesFree Chapter19:01Gastroesophageal Reflux Disease19:28Paper Chase #4 | Neuroimaging For Recurrent Seizures4:39Excellence in the Physical Exam Series | Anterior Cruciate Ligament Injuries7:34STI Testing - Is Urine Enough?12:23Paper Chase #5 | Risk of SBI In Infants With Suspected Viral Infections4:21Decision Fatigue15:09The Summary7:44
Excellence in the Physical Exam Series | Anterior Cruciate Ligament Injuries
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A relatively new physical exam maneuver called the Lever test (also known as Lelli's test) looks promising as a potential new gold standard for ACL tears. The fist of one hand is placed under the patient's proximal calf, while the other hand grabs the patients's distal thigh just above the knee. A downward force is applied to the distal thigh. If the ACL is intact, the heel of the affected leg will be lifted off of the bed. If the ACL is torn, then the femur will just slide on the tibia, and the heel will stay rested on the bed. It's intuitive, it's easy, and two studies (see below) both showed this test to be superior to the Lachman, Anterior Drawer and Pivot Shift tests.