How do you perform the Quadriceps Active Test?

Position: Patient supine, knee flexed to 90° (drawer position).Action: Stabilize the foot. Ask the patient to slide their foot down the table (contracting the quadriceps).

What is a positive result for the Quadriceps Active Test?

Positive Test: The tibia (which was sagging posteriorly) actively shifts forward to reduce into its normal position as the quads contract.

What is the diagnostic accuracy of the Quadriceps Active Test?

Sensitivity: 54%Specificity: 97%

Quadriceps Active Test – Knee Special Test

What is it used for?

Confirming PCL Rupture.

How to Perform

Position: Patient supine, knee flexed to 90° (drawer position).
Action: Stabilize the foot. Ask the patient to slide their foot down the table (contracting the quadriceps).

Interpretation of Results

Positive Test: The tibia (which was sagging posteriorly) actively shifts forward to reduce into its normal position as the quads contract.

Diagnostic Accuracy

Sensitivity: 54%
Specificity: 97%

Clinical Context & Limitations

The Quadriceps Active Test 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 Quadriceps Active Test with complementary examination tests significantly improves overall diagnostic confidence.