DIAL TEST

(TIBIAL EXTERNAL ROTATION)

​• Test positioning

The client lies supine with the test knee in 30-degrees flexion and the ankle in neutral plantarflexion/dorsiflexion and inversion/eversion.

The therapist grasps the client's distal thigh (posteriorly) with the proximal hand and the client's ankle from the plantar surface with the distal hand.

​• Action

With the proximal hand stabilizing the subject's distal thigh, the therapist maximally externally rotates the client's lower leg (maintaining the ankle in a neutral position) and measures the amount of external rotation created between the knee and medial border of the foot.

The test is repeated with the knee in 90-degrees of flexion.

​• Positive finding

An increase of > 10-degrees of external rotation (as compared to the contralateral leg) at 30-degrees but not at 90-degrees is indicative of an isolated posterolateral corner injury.

A > 10-degree increase at both angles is indicative of injury to both the posterolateral corner and posterior cruciate ligament.

​• Special considerations & comments

This test can also be performed in a prone position with the knee flexed over the side of the table.

It has been proposed that the tibial tubercle be used as the reference point for measuring external rotation as it is a fixed landmark as compared to the mobile foot.