External Rotation Test

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 External Rotation Test

What is External Rotation Test (Kleiger Test)?

The external rotation test (alos called Kleiger Test) is used to demonstrate the integrity of the syndesmotic ligaments of the ankle joint.

This Test can also be used to assess the integrity of the medial (deltoid) ligament of the ankle complex.

 See Also: Ankle Anatomy 

How it’s Performed?

External Rotation Test Kleiger Test

What does a positive External Rotation Test mean?

Sensitivity & Specificity

A Comparative Study to determine the sensitivity and specificity of both the ankle external rotation stress test and squeeze test for syndesmotic injury secondary to lateral ankle sprain, the sensitivity and specificity of ankle external rotation test was as following:

Alonso et al.2 reported that the external rotation stress test is more reliable than the squeeze test and the dorsiflexion–compression test for diagnosing syndesmosis injuries.


  1. de César PC, Avila EM, de Abreu MR. Comparison of magnetic resonance imaging to physical examination for syndesmotic injury after lateral ankle sprain. Foot Ankle Int. 2011 Dec;32(12):1110-4. doi: 10.3113/FAI.2011.1110. PMID: 22381194.
  2. Alonso A, Khoury L, Adams R. Clinical tests for ankle syndesmosis injury: reliability and prediction of return to function. J Orthop Sports Phys Ther. 1998 Apr;27(4):276-84. doi: 10.2519/jospt.1998.27.4.276. PMID: 9549711.
  3. Clinical Tests for the Musculoskeletal System 3rd Edition.
  4. Dutton’s Orthopaedic Examination, Evaluation, And Intervention 3rd Edition.

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