Knee Orthopaedic Test: Noble's Test

Noble's Test is a physical examination technique used to assess for the presence of iliotibial band (ITB) syndrome, a common cause of lateral knee pain. It is named after Dr. James Noble, the physician who described the test in 1980.

Here are the steps to perform Noble's Test of the Knee:

1. Ask the patient to lie down on their back on an examination table, with their legs extended.
2. Flex the patient's hip to 90 degrees, keeping the knee extended.
3. Apply pressure with your thumb or index finger on the lateral femoral epicondyle (the bony bump on the outside of the knee).
4. Passively extend the patient's knee while maintaining pressure on the lateral femoral epicondyle.
5. Observe the patient's response to the maneuver. If the patient experiences pain on the lateral aspect of the knee, particularly around 30 degrees of knee flexion, the test is considered positive for ITB syndrome.
6. Repeat the test on the other knee for comparison.

References:

1. Noble, J. (1980). Iliotibial band friction syndrome in runners. American Journal of Sports Medicine, 8(4), 232-234. doi: 10.1177/036354658000800402
2. Fredericson, M., & Wolf, C. (2005). Iliotibial band syndrome in runners: Innovations in treatment. Sports Medicine, 35(5), 451-459. doi: 10.2165/00007256-200535050-00005
3. Straub, M. A., & Beatty, N. R. (2016). Iliotibial band syndrome. Sports Health, 8(4), 341-347. doi: 10.1177/1941738116643159
4. Ellis, R., Hing, W., & Reid, D. (2007). Iliotibial band friction syndrome: A systematic review. Manual Therapy, 12(3), 200-208. doi: 10.1016/j.math.2006.08.004