Squeeze Test
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Purpose
The squeeze test also known as the fibular compression test has recently been identified to be used in combination with other tests to determine the diagnosis of medical conditions like ankle sprains, arthritis and other medical conditions.[1]
Available literature suggests that it is used alongside with the ankle external rotation test (Kleigers test).[2] to aid in the diagnosis of syndesmotic ankle sprains.
Technique
The squeeze test compresses the proximal fibula against the tibia to assess the integrity of the bones, interosseus membrane, and syndesmotic ligaments. Pain occurs with fracture or diastasis and is considered positive.[3][4]
Evidence
The squeeze test has been found to have moderate reliability (kappa = 0.50) according to a study performed by Alonso et al.[6] and according to the study done by de César PC et al, the test has a sensitivity of 30% and a specificity of 93.5% for a high ankle sprain.[2]
In the study done by Sman AD et al, it is recommended that though the squeeze test has highest specificity, it would be ideal to use a combination of sensitivity and specific signs and tests to confirm ankle syndesmosis involvement.
They suggests to use the dorsiflexion-external rotation stress test along with the squeeze test to get a better diagnose along with other symptoms.[7]
The squeeze test has been found to be used in early diagnosis of arthritis in MCP and MTP joints. The sensitivity was found in conjuction with MRI-detected synovitis to be 31–33%. [8]
References
- ↑ van Dijk BT, Dakkak YJ, Krijbolder DI, van Zeben D, Tchetverikov I, Reijnierse M, van der Helm-van Mil AH. Which inflamed tissues explain a positive metatarsophalangeal squeeze test? A large imaging study to clarify a common diagnostic procedure. Rheumatology. 2022 Oct 1;61(10):4107-12.
- ↑ 2.0 2.1 de César PC, Avila EM, de Abreu MR. Comparison of magnetic resonance imaging to physical examination for syndesmotic injury after lateral ankle sprain. Foot & ankle international. 2011 Dec;32(12):1110-4.
- ↑ Birrer RB, Fani-Salek MH, Totten VY et al. Managing ankle injuries in the emergency department. The Journal of Emergency medicine. 1999;17:651-660.
- ↑ Brosky T, Nyland J, Nitz A et al: The ankle ligaments: consideration of syndesmotic injury and implications for rehabilitation, J Orthop Sports Phys Ther 21:197-205, 1995.
- ↑ Syndesmosis Squeeze Test. Available from:https://www.youtube.com/watch?v=rM9Rk1oucHM&feature=emb_logo&ab_channel=PhysicalTherapyNation
- ↑ Alonso A,Khoury L, Adams R. Clinical tests for ankle syndesmosis injury: reliability and prediction of return to function. J Orthop Sports Phys Ther. 1998 Apr;27(4):276-84.
- ↑ Sman AD, Hiller CE, Rae K, Linklater J, Black DA, Nicholson LL, Burns J, Refshauge KM. Diagnostic accuracy of clinical tests for ankle syndesmosis injury. British journal of sports medicine. 2015 Mar 1;49(5):323-9.
- ↑ Wouters F, Niemantsverdriet E, Van der Helm-van Mil A. Ab1258 the value of the squeeze test for detection of subclinical synovitis in patients with arthralgia suspicious for progression to RA.(2020).