Understanding the Kleiger's Test (External Rotation Test) Assessment
To assess the integrity of the **Distal Tibiofibular Syndesmosis** (high ankle sprain) and the **Deltoid Ligament** (medial ankle).
Watch How It's Done
How do I start?
Patient is sitting with the knee flexed to 90° and the foot hanging freely.
What happens?
The examiner stabilizes the lower leg and maximally **externally rotates the foot** (forefoot and talus) while applying a minimal distraction force.
In Plain English
What Does a Positive Result Mean?
1. **Syndesmosis Injury:** Pain localized to the **anterior/posterior tibiofibular ligaments**. 2. **Deltoid Ligament Injury:** Pain localized to the **medial joint line** (Deltoid ligament) with excessive talar displacement.
Helpful Tip:
Pain on the medial side with external rotation suggests a Deltoid ligament tear; pain proximal suggests a syndesmosis sprain.
Safety First
This guide is to help you understand what happens in a clinic. Do not try to diagnose yourself. If you have severe pain, swelling, or cannot put weight on your leg, please visit an urgent care center or your doctor immediately.
Other ankel Tests
Anterior Drawer of the Ankle
To assess the integrity of the **Anterior Talofibular Ligament (ATFL)**, the most commonly injured ligament in lateral ankle sprains.
External Rotation Stress Test (or Syndesmosis Ligament Test)
To assess the integrity of the **Distal Tibiofibular Syndesmosis** (the 'high ankle sprain' ligaments, including the AITFL and PITFL).
Figure of Eight Method of Measuring Ankle Joint Swelling
To quantitatively measure and track **ankle and foot edema (swelling)** volume over time.
Impingement sign ankle (Anterior Ankle Impingement)
To diagnose **Anterior Ankle Impingement Syndrome** (bony or soft tissue impingement at the front of the joint).