Physical Exam

Valgus Stress Test

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Video coming September 2026

How to Perform

With the patient supine, hold the ankle and place your other hand on the outer (lateral) side of the knee, then push the knee inward (apply a valgus force) to open the inner joint line — first with the knee in full extension, then at about 30° of flexion. A positive test is increased opening or pain on the inner (medial) side.

How to Interpret

Medial Collateral Ligament (MCL) Injury of the Knee

Positive valgus stress test

Rule in

Minimally helpful

Rule out

Helpful

Evidence:Limited

References

Kastelein M, Wagemakers HP, Luijsterburg PA, Verhaar JA, Koes BW, Bierma-Zeinstra SM. Assessing medial collateral ligament knee lesions in general practice. Am J Med. 2008 Nov;121(11):982-988.e2. doi:10.1016/j.amjmed.2008.05.041. PMID 18954845. Single primary cohort of 134 patients with traumatic knee injury, MRI reference standard (35 MCL lesions); valgus stress test at 30 degrees: laxity sensitivity 0.91 / specificity 0.49 (derived LR+ 1.78, LR- 0.18), pain sensitivity 0.78 / specificity 0.67 (reported LR+ 2.3). (Solomon DH et al. 2001 JAMA Rational Clinical Examination, PMID 11585485, retained as corroboration in the notes.)
McGee S. Evidence-Based Physical Diagnosis. 6th ed. Philadelphia, PA: Elsevier; 2025.