Special Tests for Orthopedic Examination, ed 3.

Special Tests for Orthopedic Examination, ed 3

Konin JG, Wiksten DL, Isear JA Jr, Brader H. Thorofare, NJ 08086, Slack Inc, 2006, spiralbound, 400 pp, illus, ISBN: 1-55642-741-7, $38.95.

This text, authored by both physical therapists and athletic trainers, is intended to provide a condensed guide for the examination of people with orthopedic injuries. In my opinion, this goal has been surpassed.

Designed as a "pocket-style" manual, the 400 pages in this third edition push the definition of "pocket guide," but make up for the additional size with an abundance of information. Designed for physical therapists, athletic trainers, physicians, physician assistants, and occupational therapists, this text covers a plenitude of orthopedic tests. Like other texts of this kind, the special tests in this book are organized into 12 sections according to the major spinal segments and peripheral joints. A total of 155 special tests are offered, ranging from as few as 3 for the temporomandibular joint and thoracic spine sections to as many as 34 for the shoulder. In addition to the joint-by-joint arrangement, an alphabetical index at the end of the text allows the reader to search for tests by name.

Significant improvements from the first and second edition are evident. The authors have removed tests not supported by the literature and replenished this third edition with relevant, special tests with greater scientific support. New to this third edition is the inclusion of references that accompany the presentation of each special test. Although references were included in earlier editions following each chapter, the authors have attempted to include pertinent peer-reviewed literature immediately following the description and depiction of each test. These references are offered as support for the tests and, in many cases, to provide information regarding the historical, anatomical, and comparative issues related to each test. This evidence-based approach is a distinguishing factor of this third edition. The authors, in recognizing the lack of evidence for many currently popular tests, challenge the reader to develop their own conclusions and clinical support for the tests.

The final section, "Contemporary Special Tests," also is new to this edition, and it offers 5 novel, but increasingly popular, tests. These include the impingement reduction test, the walking arm stress test, the finger extension test, the flexor pronator syndrome test, and the tarsal twist test. The book's new spiralbound design facilitates practical use, allowing the reader to lay the text open while performing or practicing a test. Besides increased ease of use, the spiralbound feature eliminates cracked bindings and loose pages, that result from repetitively prying the text open and laying it flat for better viewing. The 8 1/2-in x 5 1/2-in size and 400 pages may not be a true "pocket guide," but the pages are much easier to view than many smaller guides that require the reader to view the tests from a short distance while performing the tests.

Each test is neatly and concisely organized with the corresponding photographs on the adjacent page and with the following subsections: (1) "Test Position," which describes the appropriate positioning of the examiner and the patient; (2) "Action," which describes the examiner's movement specific to the test and, as appropriate, the associated action of the patient; (3) "Positive Finding," which describes the associated response to the test action that would indicate a positive test; (4) "Special Considerations/Comments," which offers points of clarification, experience-based suggestions, and special situations regarding the tests; and, for most tests, (5) "References," for further information. Inclusion of these clearly delineated subsections instead of continuous paragraphs greatly facilitates use by allowing the reader to locate the desired information.

Each special test is accompanied by one or more black-and-white photos clearly depicting the position of the examiner and the patient. Another new and very instructive feature of this third edition is the placement of arrows demonstrating the test movement, or action, of the examiner and the appropriate action of the patient.

The tests in this guide represent a wide variety of the common and widely used tests, which are often considered "entry-level," to the lesser known or rarer tests, which are sometimes used by clinicians who have greater experience. A pleasing feature of this text is the focus on the special tests. Unlike other texts that cover special tests, this particular text does not veer from its focus by offering reviews of joint anatomy, physiology, or pathology. In this manner, the text remains true to its purpose and packs a load of content in each section.

This text offers much information to those clinicians with limited experience in orthopedic examination. With the addition of peer-reviewed references for each test and new or contemporary tests, even the experienced orthopedic clinician find this text useful. Its organization and ease of use are very appearing features. I recommend this text to anyone involved in the examination of orthopedic injury.

[DOI: 10.2522.ptj.2006.86.9.1311.1]

James W Bellew, PT, EdD

Louisiana State University Health Science Center--Shreveport

Shreveport, La

Bellew is Associate Professor in the Department of Physical Therapy. He has authored mare than 25 articles and chapters on various topics and currently teaches electrophysiology and exercise physiology.