Dial Test

Other Names

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Dial test performed with the patient in prone position with the knees flexed to 90° and 30°. The knees are flexed to 90° in the left photograph and 30° in the right photograph.

Dial test at 8 months. Positive at 90 ° on the right knee and equal at 30 ° indicating PCL laxity with an intact posterolateral corner.

Modified dial test in the supine position

• External rotation test
• Loomer Test
• Tibial External Rotation Test
• External Rotation Test
• Foot-Thigh Angle Test
• Prone External Rotation Test

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Purpose

• Evaluate for posterolateral instability of the joint, specifically the Posterolateral Corner
• Contents of posterolateral corner include:
  • Lateral Collateral Ligament
  • Popliteus complex
  • Popliteofibular ligament
  • Posterolateral capsule
• The goal of the test is to the degree of external rotation at the knee
• First described by Loomer in 1991

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Description

• The patient should be prone with examiner at the foot of the bed
• Knees flexed to 30° with hands on patients feet the examiner externally rotates the leg
• The foot-thigh angle is measured and compared to the unaffected limb
• The knees are then flexed to 90° and the external rotation is again performed
• A positive test
  • Increase in external rotation, typically by more than 10° compared to the unaffected knee
  • Note that this test can often be "eye balled" and objective measurement is not necessarily required

Modification

• This test has been described in the supine position (see image)
• Interpretation of the test is the same

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Pathology

• Posterolateral Corner Injury
• PCL Injury

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Evidence

Isolated Posterolateral Corner Injury

• Norris et al
  • Sensitivity: 20%
  • Specificity: 100%
  • PPV: 1.0
  • NPV: 0.70

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See Also

• Knee Pain Main
• Physical Exam Knee
• Knee Anatomy Main

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