National Physical Therapy Examination (NPTE) Practice Exam

A patient with a grade III ligamentous sprain of the radial collateral ligament would MOST likely exhibit pain during which test?

1. Passive range of motion test

2. Valgus stress testing

3. Resisted isometric testing of the abductor pollicis longus

4. Palpation of the radial portion of the metacarpophalangeal joint

The correct answer is: Palpation of the radial portion of the metacarpophalangeal joint

Pain during palpation of the radial portion of the metacarpophalangeal joint is a significant indicator of a grade III ligamentous sprain of the radial collateral ligament. In this type of injury, the ligament is completely torn, resulting in instability and a loss of support for the joint. Palpation over the area where the radial collateral ligament attaches will likely elicit pain, as the damaged ligament is directly affected. This type of sprain leads to inflammatory responses, swelling, and tenderness, making palpation particularly sensitive in the area of injury. The degree of damage associated with a grade III sprain means that the ligament cannot adequately stabilize the joint, contributing to localized pain upon examination. While the other tests mentioned may also provide some insight into the injury, they are less likely to elicit significant pain specific to the injury than palpation of the damaged ligament during physical examination.