Kleiger's Test

Original Editor - Khloud Shreif
Top Contributors - Khloud Shreif and Kim Jackson

Purpose[edit | edit source]

Interosseous membrane.JPG

Kleiger's test or external rotation is used for the diagnosis of a medial ankle sprain, to assess the deltoid ligament sprain and inferior tibiofibular syndesmotic sprain[1].

Technique[edit | edit source]

Patient position: in a seated position, with knee hanging in 90 degrees, ankle relaxed.

Examiner: sitting at the level of the ankle to be tested with one hand stabilizing the leg from behind, the other hand grasp the ankle in neutral position then externally rotation of the foot. Nussbaum et al performed the test with the ankle fully dorsiflexed[1].

Test positive: if there is pain at the site of the interosseous membrane, or medially. Pain may radiate upward to the leg depending on the severity of the injury.


Evidence[edit | edit source]

Interrater reliability 0.75 according to kappa[3]. and a sensitivity of 25% and specificity of 84.8% when comparing the test with MRI finding[1].

With ankle dorsiflexion, the sensitivity of 75%, and the positive LR = 1.93[4].

References[edit | edit source]

  1. 1.0 1.1 1.2 Larkins L, Baker R, Baker J. Physical Examination of the Ankle: A Review of the Original Orthopedic Special Test Description and Scientific Validity of Common Tests for Ankle Examination. Archives of Rehabilitation Research and Clinical Translation. 2020 Jul 8:100072.
  2. Ortho EVAL Pal With Paul Marquis. Kleiger's test for High Ankle Sprain/Special Test for the Ankle. Available from: http://www.youtube.com/watch?v=AXPxMmChQj0[last accessed 26/2/2020]
  3. Alonso A, Khoury L, Adams R. Clinical tests for ankle syndesmosis injury: reliability and prediction of return to function. Journal of Orthopaedic & Sports Physical Therapy. 1998 Apr;27(4):276-84.
  4. 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.