Physical examination maneuver

Physical Exam

Ankle Dorsiflexion-external Rotation Test

also known as Kleiger test
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How to Perform

With the patient seated, stabilize the lower leg with one hand and grasp the foot with the other. Dorsiflex the ankle, then externally rotate the foot relative to the lower leg. A positive test is pain over the distal tibiofibular syndesmosis.

How to Interpret

Showing all 1 finding

Ankle Syndesmosis Injury

Dorsiflexion-external rotation stress test positive
Rule in
InconclusiveWide CI
Rule out
InconclusiveWide CI
Evidence:Strong

References

  • Netterström-Wedin F, Bleakley C. Diagnostic accuracy of clinical tests assessing ligamentous injury of the ankle syndesmosis: a systematic review with meta-analysis. Phys Ther Sport. 2021 May;49:214-226. doi:10.1016/j.ptsp.2021.03.005. PMID: 33774464.
  • Kleiger B. The mechanism of ankle injuries. J Bone Joint Surg Am. 1956;38-A(1):59-70.

Research last updated September 10, 2026.