Dial Test (Tibial External Rotation) Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Differentiating between isolated Posterolateral Corner (PLC) injury and combined PCL + PLC injury.
How to Perform
- Position: Patient lies prone (or supine).
- Action: Externally rotate both feet at 30° of knee flexion. Repeat at 90° of knee flexion.
Interpretation of Results
- >10° difference at 30° only: Isolated PLC injury.
- >10° difference at 30° AND 90°: Combined PCL + PLC injury.
Clinical Context & Limitations
The Dial Test (Tibial External Rotation) should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Knee region, combining the Dial Test (Tibial External Rotation) with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
- Miller, M. D. (2020). Miller's Review of Orthopaedics.
