Knee Orthopaedic Test: Dial Test

The Dial Test of the Knee is a clinical exam used to diagnose the extent of the damage to the cruciate ligaments in the knee. It involves externally rotating the tibia (lower leg bone) while the femur (upper leg bone) is held stable to assess the amount of medial or lateral rotation in the knee.

Here is a step-by-step procedure for performing the Dial Test of the Knee:

1. Ask the patient to lie down on their back with their knee bent to 90 degrees.
2. Stabilize the patient's thigh with one hand, while holding the patient's foot with the other hand.
3. Rotate the foot and lower leg outwards (externally rotate) while keeping the thigh and upper leg stable.
4. Observe the amount of medial or lateral rotation in the knee joint while externally rotating the foot.
5. Repeat the test with the patient's foot and lower leg in a neutral position and then with internal rotation.
6. Compare the results of the test with the unaffected knee and note any differences in medial or lateral rotation.
7. Interpret the test results and correlate them with other diagnostic tests to determine the extent of the damage to the cruciate ligaments.

It is important to note that the Dial Test of the Knee should only be performed by a trained medical professional and should not be attempted by patients or non-medical personnel. Additionally, it should not be performed on patients with an acute knee injury, as it may exacerbate the injury.

References:

1. Pacher, N., & Lattanzi, R. (2018). Knee ligament testing. In Essential Procedures for Practitioners in Emergency, Urgent, and Primary Care Settings: A Clinical Companion (pp. 169-174). Springer.
2. Eguchi, Y., Ochi, M., Adachi, N., & Deie, M. (2017). Evaluation of rotational instability in the posterior cruciate ligament-deficient knee using the dial test. Clinical Journal of Sport Medicine, 27(3), 283-288.
3. Song, G. Y., Zhang, H., Wang, Q. G., Zhang, J., Li, Y., Feng, H., & Li, X. (2015). Meta-analysis of the accuracy of the dial test for detecting posterior cruciate ligament rupture. Knee Surgery, Sports Traumatology, Arthroscopy, 23(3), 699-706.
4. Kennedy, N. I., Wijdicks, C. A., Goldsmith, M. T., Michalski, M. P., Devitt, B. M., & LaPrade, R. F. (2013). Kinematic analysis of the posterior cruciate ligament, part 2: a comparison of anatomic single- versus double-bundle reconstruction. The American Journal of Sports Medicine, 41(12), 2839-2848.