Ballottement

While maintaining pressure with the first hand, use the index finger of the other hand to sharply push the patella downward toward the femur (thigh bone). Findings:

This test is highly specific for large effusions but may miss smaller amounts of fluid, which are better detected using the Bulge Sign . 2. Obstetric Ballottement ballottement

Suspected knee trauma, arthritis flare-up, or unexplained swelling. Technique: While maintaining pressure with the first hand, use

The patella is already in contact with the bone; there is no sensation of floating or clicking. This "milks" fluid out of the suprapatellar pouch

Use one hand to firmly stroke downward from the mid-thigh toward the kneecap. This "milks" fluid out of the suprapatellar pouch and into the space behind the patella.

The clinician inserts two fingers into the vagina and gives a sharp upward tap against the lower segment of the uterus. If the fetus is present and not yet engaged in the pelvis, it will float upward and then fall back, tapping against the clinician’s fingers.