Physical examination maneuver

Physical Exam

Ankle Dorsiflexion-external Rotation Test

also known as Kleiger test
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Video coming September 2026

How to Perform

With the patient seated and the knee flexed to 90° (lower leg hanging), stabilize the lower leg with one hand and grasp the foot with the other; hold the ankle in a neutral-to-dorsiflexed position and externally rotate the foot. A positive test is pain over the distal tibiofibular syndesmosis (anterolateral ankle).

How to Interpret

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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.