Ankle and foot
External rotation stress test
Kleiger-test
- What you examine
- Injury of the distal tibiofibular syndesmosis.
- Procedure
- Sitting with the knee flexed 90 degrees and the lower leg free. Fix the lower leg and forcefully rotate the foot outward in neutral dorsiflexion.
- Positive when
- Pain high at the front of the ankle, between tibia and fibula, and not over the lateral ligaments.
- What the test is worth
- Sensitivity around 0.20 to 0.70 depending on the study, specificity around 0.85. Stronger combined with the squeeze test and tenderness over the syndesmosis.
- Caution
- A missed syndesmotic injury recovers far more slowly than an ordinary sprain, and the patient still complaining after six weeks often has one. So test for it in every ankle sprain.
- Body region
- Ankle and foot