Comprehensive Osteopathic Medical Licensing Examination (COMLEX USA) Practice

Which tests are traditionally used to assess ACL injury?

1. Varus and valgus stress tests

2. Anterior and posterior drawer tests

3. Flexibility and strength tests

4. X-rays and MRIs

The correct answer is: Anterior and posterior drawer tests

The anterior and posterior drawer tests are the traditional clinical assessments specifically used to evaluate anterior cruciate ligament (ACL) injuries. These tests are designed to assess the stability of the knee joint by evaluating the movement of the tibia relative to the femur. During the anterior drawer test, the examiner stabilizes the patient's foot while pulling the tibia forward. If the ACL is intact, the tibia will not move excessively forward. A significant amount of forward movement suggests a potential ACL tear. The posterior drawer test, on the other hand, assesses the posterior cruciate ligament (PCL) by pushing the tibia backward, but it is included in the ACL injury assessment context as well because it helps rule out or identify other ligamentous injuries. Other tests listed, such as the varus and valgus stress tests, are more focused on assessing the lateral and medial stability provided by the collateral ligaments rather than the ACL. Flexibility and strength tests are general assessments and do not specifically target ligamentous integrity. While imaging techniques like X-rays and MRIs can aid in the diagnosis of ACL injuries, they are not traditional physical examination tests specifically designed to assess ligament integrity but are supplementary tools used for further evaluation following initial physical assessment.