Patellofemoral Grind Test (Clarke’s Sign) Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Detecting Chondromalacia Patella or Patellofemoral Pain Syndrome (PFPS).
How to Perform
- Position: Patient supine, knee extended.
- Action: Examiner places the web of the hand proximal to the patella and pushes it distally.
- Command: Ask patient to contract quadriceps.
Interpretation of Results
- Positive Test: Retropatellar pain or inability to hold the contraction.
- Warning: High rate of false positives; can be painful even for normal knees. Use caution.
Clinical Context & Limitations
The Patellofemoral Grind Test (Clarke’s Sign) 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 Patellofemoral Grind Test (Clarke’s Sign) with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
