Jolt Test / Nakajima N-Test | Anterior Cruciate Ligament Tear
Around the time that the Pivot Shift test of Macintosh for the ACL was proposed, Nakajima et al. (1972) observed a similar jolt of the ACL-deficient knee during examination using their “n-test”. However, this procedure has not undergone diagnostic accuracy assessment and the clinical value thus remains questionable.
To conduct the test, the patient is in supine lying position. We are going to describe the procedure for the right knee.
The patient’s knee is flexed to 90°. Using your right hand, pick up the patient’s leg by grasping the lateral side of the ankle and applying internal rotation.
Your left hand rests on the lateral aspect of the patient’s knee and applies a valgus force. At the same time, place your thumb on the posterior aspect of the head of the fibula.
The knee is then gradually extended.
The test is positive if the tibial plateau suddenly subluxates anteriorly and medially with a palpable jolt that usually occurs at around 40-20 degrees of extension. The patient may also report that sensation as the “giving-way” feeling they experience during activities.
21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE
What customers have to say about the Assessment E-Book
The Assessment E-Book This book helped me in my studying for my exam and in assessing my first patients. Awesome! Also for beginners!
The Assessment E-Book It’s an amazing Compilation! Congrats to all the work you have put in there. You’ll propably find all the test’s you’ve been looking for with propper explaination and source to doublecheck for you self. definetly a must have for every student, but it will also help an experienced practioner. Im looking forward to the lifelong updates on the topics.
Great work, guys
The Assessment E-Book A must-have for all physiotherapists, osteopaths and manual therapists. The authors conducted an extensive research on assessment tests in manual therapy. I find it very easy to read. The more I read the more I learn. Thank you!
The Assessment E-Book This book is great! It is very structured and detailed. It works extremely well on my Macbook and iPad.
The Assessment E-Book The best way to spend 80euros. Totally worth it. The amount of work you put behind this must have been absolutely huge. Every physical or physiotherapist should own it.
Congrats guys you’ve done an incredible job.
I’ve learnd a lot of new things and my approach to therapy in general have totally changed.
In one word: amazing. Keep going guys ! Best wishes from france.
This content is for members
Create your free account to gain access to this exclusive content and more!
The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network.
The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user.
The technical storage or access that is used exclusively for statistical purposes.The technical storage or access that is used exclusively for anonymous statistical purposes. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you.
The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes.