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Performing the Dial Test to assess for posterolateral rotatory instability of the knee

This is an excerpt from The Pocket Atlas of Special Tests for the Lower Limb by Jane Johnson.

Purpose: This is used to assess for posterolateral rotatory instability of the knee.

Type of Test: This is a passive joint movement test.

Procedure: There are two parts to this test. With your client prone, passively flex their knees to approximately 30°. Next, passively place the ankles into maximal dorsiflexion. Grasping the feet, maximally rotate the tibia into lateral rotation (figure 9.10). Observe for posterior rotation of the lateral side of the tibia. Measure the foot-thigh angle. Repeat this with the knees passively flexed to 90° (figure 9.11).

Findings: A difference in the amount of tibial rotation indicates posterolateral instability on the leg where the rotation is greatest. At 30° of knee flexion, a difference of 10° is considered significant for a posterolateral corner knee tear. If a difference of 10° in external rotation is found at both 30° and 90° of knee flexion, this indicates damage to both the posterolateral corner of the knee as well as the posterior cruciate ligament.

Tip: There is a good description of posterolateral knee anatomy, injuries, tests, and treatment by Cooper, McAndrews, and LaPrade (2006). This test may also be performed with your client in the supine position.

More Excerpts From The Pocket Atlas of Special Tests for the Lower Limb

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