McConnell Test is a provocative test that is used to evaluate the tracking of the knee patellofemoral joint.
See Also: Patellar Tendinitis
The patient is seated with the legs relaxed and hanging over the edge of the table.
This test attempts to provoke patellofemoral pain with isometric tensing of the quadriceps. This is done with the knee in various degrees of flexion (0°, 30°, 60°, and 120°).
In each position, the examiner immobilizes the patient’s lower leg and asks the patient to extend the leg against the examiner’s resistance (this requires contraction of the quadriceps).
Where the patient reports pain or a subjective sensation of constriction, the examiner medially displaces the patella with his or her thumb. In a positive McConnell Test , this maneuver reduces pain.
The examination should always be performed comparatively on both knees. Alleviation of pain by medial displacement of the patella is a diagnostic criterion for the presence of retropatellar pain.
In a positive McConnell test, pain can often be reduced by taping the knee so as to pull the patella medially. This “McConnell tape” bandage includes a lateral to medial slip that pulls the patella medially. A small plaster slip running medially from the middle of the patella is applied where a lateral patellar tilt requires correction.
If required, a rotational slip extending from the medial knee to the tip of the patella and then to the lateral aspect can be applied to bring the patella into a neutral position.
Physical therapy should concentrate on strengthening the vastus medialis and stretching the rectus femoris and iliotibial tract.
Facet Tenderness Test is another test used to evaluate the pain arising from the knee patellofemoral joint.
The patient is placed in supine position with the knee extended. The examiner first elevates the medial margin of the patella with his or her thumbs and palpates the medial facet with a thumb, then elevates the lateral margin with the index fingers and palpates the lateral facet with an index finger. Elevating the patella allows palpation of the retropatellar region, which is important in disorders such as chondromalacia.
Patients with retropatellar osteoarthritis, tendinitis, or synovitis will report pain, especially when the examiner palpates the medial facet.
Tenderness to palpation at the distal pole of the patella can be a sign of patellar tendinitis (“jumper’s knee”).