Purpose: To assess for a fracture in the lower extremity.
Test Position: Supine.
Performing the Test: The patient should not be wearing shoes. The examiner then strikes the heel of the patient. A positive test is reproduction of the patient's worst pain.
Diagnostic Accuracy: Unknown.
Importance of Test:Our bones are covered by a layer of tissue known as the periosteum. It is highly innervated and very sensitive to injury. When a bone is fractured, the periosteum is more easily stimulated and thus pain is experienced. By striking the heel of the foot, a large vibratory/compression force is sent through the limb that stimulates the injured site. It should be noted that the percussion test can produce pain in non-musuloskeletal ailments as well, such as psoas abscess, appendicitis, etc. It is important to utilize your subjective history, tests and measures, and general systems screenings to triangulate your findings.
Note: these tests should only be used by properly trained health care practitioners.