Dial Test: Difference between revisions

Revision as of 05:09, 6 October 2014

Original Editors - Gaelle Vertriest as part of the Vrije Universiteit Brussel's Evidence-based Practice project

Top Contributors - Tomer Yona, Gaëlle Vertriest, Rachael Lowe, Admin, Kim Jackson, Yvonne Yap, Daphne Jackson, Uchechukwu Chukwuemeka, Tony Lowe, Kai A. Sigel, WikiSysop and Wanda van Niekerk

Definition/Description[edit | edit source]

Purpose[edit | edit source]

The purpose of the ‘Dial Test’ is to diagnose posterolateral instability. By performing the test, we can detect whether there’s an isolated or combined injury of the knee. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

An injury to only one or two structures of the knee must be investigated by the dial test, other clinical tests en diagnostic methods. That can be physical examinations, magnetic resonance imaging, radiographs, and patient’s history. For an isolated PCL-tear, the posterior drawer test or sag tests are more provocative. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

Clinically Relevant Anatomy[edit | edit source]

The dial test is clinically valuable when three structures are injured. These three posterolateral structures may be the popliteus tendon, the popliteofibular ligament (PFL) and the lateral collateral ligament (LCL). It may also be a combined injury with the posterior cruciate ligament (PCL) and two other posterolateral structures. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

Technique
[edit | edit source]

It is possible to do the test both in a prone and supine position, and is performed in both 30° and 90° knee flexion. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title The dial test inspects the external rotation at the knee joint. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

The patient is in prone: performing the test is sensitive to the notice of a PLC-injury in a PCL-injured knee. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title The knees are held together and bent at 30°, the therapist stands behind the table and keeps the feet in dorsiflexion. He turns the lower legs and feet outwards and compares the motion of the feet. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Repeat the test with the knees at 90°. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

- www.youtube.com/watch Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

The patient is in supine: there are 2ways to perform this test.
1) As in prone position: the knees are held together and bent at 30°, the therapist stands behind the table and keeps the feet in dorsiflexion. He turns the lower legs and feet outwards and compares the amount of rotation of the tibial tubercle. Repeat the test with the knees at 90°. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

- www.youtube.com/watch Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

2) One leg is hanging off the edge of the table with the knee in 30° of flexion. The therapist stands beside the table and stabilizes the thigh with one hand; the other hand executes an external rotation of the foot. By observing the tibial tubercle motion, we can indicate any posterolateral knee injury. With an increase, compare to the normal contralateral side. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

If the dial test at 30° is positive, perform the test when the knee is flexed on 90°. The thigh does not touch the table, hold the leg in your hands or put the foot down on the table. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

Key Research[edit | edit source]

add links and reviews of high quality evidence here (case studies should be added on new pages using the case study template)

Resources
[edit | edit source]

add appropriate resources here

Evaluation[edit | edit source]

The evaluation of the test for both prone and supine position:
The dial test is positive when there is more than 10° of external rotation in the injured knee compared to the uninjured knee. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

Standard injury	Mild injury	Moderate injury	Severe Injury
<5°	6-10°	11-19°	>20°

Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

There are different injuries:
- An isolated injury to the PLC: more than 10° of external rotation in the injured knee is present at 30° of flexion, but not at 90° of flexion. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
- Instability of the PCL: more than 10° of external rotation in the injured knee is present at 90° of flexion, but not at 30° of flexion. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title
- A combined injury: more than 10° of external rotation in the injured knee is present at 30° and 90° of flexion. This is an injury of the PCL and the PLC. Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title

Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

@@ Line 1: / Line 1: @@
-<div class="noeditbox">Welcome to [[Vrije Universiteit Brussel Evidence-based Practice Project|Vrije Universiteit Brussel's Evidence-based Practice project]]. This space was created by and for the students in the Rehabilitation Sciences and Physiotherapy program of the Vrije Universiteit Brussel, Brussels, Belgium. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!</div> <div class="editorbox">
+<div class="editorbox">
-'''Original Editors ''' - [[User:Gaelle Vertriest|Gaelle Vertriest]]
+'''Original Editors ''' - [[User:Gaelle Vertriest|Gaelle Vertriest]] as part of the [[Vrije Universiteit Brussel Evidence-based Practice Project|Vrije Universiteit Brussel's Evidence-based Practice project]]
+'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div>
-'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} - Your name will be added here if you are a lead editor on this page.&nbsp;
-</div>
-== Search Strategy  ==
-<u>''Keywords:''</u>
-Dial test, posterior knee pain, tibial external/internal rotation test, posterolaterale exorotatietest, knee tests, instability tests, knee injury<br>
-''<u>Databases searched:</u>''
-Medscape, Pedro, Google Scholar, Pubmed, Cochrane library, Web of Knowledge, Library of the VUB<br>
 == Definition/Description  ==
 <br>
 == Purpose  ==
-The purpose of the ‘Dial Test’ is to diagnose posterolateral instability. By performing the test, we can detect whether there’s an isolated or combined injury of the knee. <ref name="2" />&nbsp;<ref name="4">http://www.arthroscopyjournal.org/article/S0749-8063(07)01108-5/abstract  Level of evidence: A2/B</ref>&nbsp;<ref name="7">http://www.physicaltherapynation.com/index.php?option=com_zoo&amp;amp;amp;amp;amp;amp;amp;task=item&amp;amp;amp;amp;amp;amp;amp;item_id=429&amp;amp;amp;amp;amp;amp;amp;Itemid=12  Level of evidence: D</ref>&nbsp;<ref name="12">http://www.sportsdoc.umn.edu/clinical_folder/knee_folder/knee_exam/dial%20text.htm  Level of evidence: D</ref>&nbsp;
+The purpose of the ‘Dial Test’ is to diagnose posterolateral instability. By performing the test, we can detect whether there’s an isolated or combined injury of the knee. <ref name="2" />&nbsp;<ref name="4">http://www.arthroscopyjournal.org/article/S0749-8063(07)01108-5/abstract  Level of evidence: A2/B</ref>&nbsp;<ref name="7">http://www.physicaltherapynation.com/index.php?option=com_zoo&amp;amp;amp;amp;amp;amp;amp;amp;amp;task=item&amp;amp;amp;amp;amp;amp;amp;amp;amp;item_id=429&amp;amp;amp;amp;amp;amp;amp;amp;amp;Itemid=12  Level of evidence: D</ref>&nbsp;<ref name="12">http://www.sportsdoc.umn.edu/clinical_folder/knee_folder/knee_exam/dial%20text.htm  Level of evidence: D</ref>&nbsp;
 An injury to only one or two structures of the knee must be investigated by the dial test, other clinical tests en diagnostic methods. That can be physical examinations, magnetic resonance imaging, radiographs, and patient’s history. For an isolated PCL-tear, the posterior drawer test or sag tests are more provocative. <ref name="1">Edell D., Posterior Knee Pain: Several Common Possibilities,The Atletic Advisor, Richmond, TX 77469, January 2005, volume 10, issue 6.  (http://www.athleticadvisor.com/injuries/le/knee/posterior_knee_pain.htm)  (http://www.athleticadvisor.com/images/Acrobat/AtAd%2010-06%20Post%20Knee%20PDF.pdf)  Level of evidence: D</ref>&nbsp;<ref name="2">English S. D. Perre D., posterior knee pain, Humana Press, CA, USA, Curr Rev Musculoskelet Med (2010) 3:3-10  (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941578/)  Level of evidence: A1</ref>&nbsp;<ref name="4" /><br>
 == Clinically Relevant Anatomy  ==
 The dial test is clinically valuable when three structures are injured. These three posterolateral structures may be the popliteus tendon, the popliteofibular ligament (PFL) and the lateral collateral ligament (LCL). It may also be a combined injury with the posterior cruciate ligament (PCL) and two other posterolateral structures. <ref name="2" />&nbsp;<ref name="4" />&nbsp;<ref name="8">http://www.kneejointsurgery.com/html/ligament/posterolateral_corner.htmlfckLRLevel of evidence: D</ref>&nbsp;<br>
 == Technique<br>  ==
-It is possible to do the test both in a prone and supine position, and is performed in both 30° and 90° knee flexion. <ref name="1" />&nbsp;<ref name="2" />&nbsp;<ref name="9">Covey C.D.C., Injuries of the Posterolateral Corner of the Knee, the journal of bone; joint surgery, Washington, January 2001, volume 83-A, number 1: 106-118.  (http://www.med.tu.ac.th/ortho/New%20journal/PL%20corner%20of%20the%20knee.pdf)  Level of evidence: A1</ref>&nbsp;<ref name="13">http://www.youtube.com/watch?v=vzBlb78r0NQ&amp;amp;amp;amp;NR=1  Level of evidence: D</ref>&nbsp;The dial test inspects the external rotation at the knee joint. <ref name="2" />&nbsp;<ref name="5">http://www.physicaltherapy.yolasite.com/diseases-and-management/knee-pain  Level of evidence: D</ref>&nbsp;<ref name="7" />&nbsp;<ref name="9" />
+It is possible to do the test both in a prone and supine position, and is performed in both 30° and 90° knee flexion. <ref name="1" />&nbsp;<ref name="2" />&nbsp;<ref name="9">Covey C.D.C., Injuries of the Posterolateral Corner of the Knee, the journal of bone; joint surgery, Washington, January 2001, volume 83-A, number 1: 106-118.  (http://www.med.tu.ac.th/ortho/New%20journal/PL%20corner%20of%20the%20knee.pdf)  Level of evidence: A1</ref>&nbsp;<ref name="13">http://www.youtube.com/watch?v=vzBlb78r0NQ&amp;amp;amp;amp;amp;amp;NR=1  Level of evidence: D</ref>&nbsp;The dial test inspects the external rotation at the knee joint. <ref name="2" />&nbsp;<ref name="5">http://www.physicaltherapy.yolasite.com/diseases-and-management/knee-pain  Level of evidence: D</ref>&nbsp;<ref name="7" />&nbsp;<ref name="9" />
 The patient is in prone: performing the test is sensitive to the notice of a PLC-injury in a PCL-injured knee. <ref name="2" />&nbsp;The knees are held together and bent at 30°, the therapist stands behind the table and keeps the feet in dorsiflexion. He turns the lower legs and feet outwards and compares the motion of the feet. <ref name="5" />&nbsp;<ref name="6">Brooijmans R., Huiberts L., Hekking J., Lataster A., Kan de fysiotherapeut acute knieletsels adequaat diagnosticeren?, www.physios.nl, Maastricht, Maart 2011, nummer 1: 38-46.  (http://www.b-sis.nl/publicaties/Physios-2011-1-5.pdf)  Level of evidence: A1</ref>&nbsp;Repeat the test with the knees at 90°. &nbsp;<ref name="6" />&nbsp;<ref name="13" />
@@ Line 46: / Line 34: @@
 If the dial test at 30° is positive, perform the test when the knee is flexed on 90°. The thigh does not touch the table, hold the leg in your hands or put the foot down on the table. <ref name="7" />&nbsp;<ref name="11">http://www.sportsdoc.umn.edu/Clinical_Folder/Knee_Folder/Knee_Exam/dialtest%20at%2090.htm  Level of evidence: D</ref>&nbsp;<ref name="12" />
 <br>[[Image:Dial test 90.jpg]]&nbsp; <ref name="11" /><br><br>
 == Key Research  ==
@@ Line 58: / Line 46: @@
 == Evaluation  ==
-The evaluation of the test for both prone and supine position:<br>The dial test is positive when there is more than 10° of external rotation in the injured knee compared to the uninjured knee. &nbsp;<ref name="2" />&nbsp;<ref name="3">Lawless M.W., Andrisani D.M., Posterior Cruciate Ligament Pathology, Medscape reference, Drugs, Diseases &amp;amp;amp; Procedures, 21september 2010,  (http://emedicine.medscape.com/article/1252128-overview#a0112)  Level of evidence: A1</ref>&nbsp;<ref name="9" />&nbsp;<ref name="10" />&nbsp;<ref name="12" />
+The evaluation of the test for both prone and supine position:<br>The dial test is positive when there is more than 10° of external rotation in the injured knee compared to the uninjured knee. &nbsp;<ref name="2" />&nbsp;<ref name="3">Lawless M.W., Andrisani D.M., Posterior Cruciate Ligament Pathology, Medscape reference, Drugs, Diseases &amp;amp;amp;amp;amp; Procedures, 21september 2010,  (http://emedicine.medscape.com/article/1252128-overview#a0112)  Level of evidence: A1</ref>&nbsp;<ref name="9" />&nbsp;<ref name="10" />&nbsp;<ref name="12" />
 <br>
-{| width="600" border="1" cellpadding="1" cellspacing="1"
+{| width="600" cellspacing="1" cellpadding="1" border="1"
 |-
 | Standard injury
@@ Line 77: / Line 65: @@
 &nbsp;<ref name="6" />
 <br>There are different injuries:<br>&nbsp; &nbsp; - An ''isolated injury'' to the PLC: more than 10° of external rotation in the injured knee is present at 30° of flexion, but not at 90° of flexion. <ref name="1" />&nbsp;<ref name="2" />&nbsp;<ref name="6" />&nbsp;<ref name="3" />&nbsp;<ref name="7" />&nbsp;<ref name="9" />&nbsp;<ref name="11" /><br>&nbsp; &nbsp; - Instability of the PCL: more than 10° of external rotation in the injured knee is present at 90° of flexion, but not at 30° of flexion. <ref name="7" />&nbsp;<ref name="11" /><br>&nbsp; &nbsp; - A ''combined injury'': more than 10° of external rotation in the injured knee is present at 30° and 90° of flexion. This is an injury of the PCL and the PLC. <ref name="6" />&nbsp;<ref name="7" />&nbsp;<ref name="9" />&nbsp;<ref name="11" /><br><br>
 == Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
-see tutorial on [[Adding PubMed Feed|Adding PubMed Feed]]
 <div class="researchbox">
-<rss>Feed goes here!!|charset=UTF-8|short|max=10</rss>
+<rss>https://www.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1jue2dFuI_LNj0oPWak3TlgiK4yZ-f2qBZrJ3hLVgRrdLy89uW|charset=UTF-8|short|max=10</rss>
 </div>
 == References  ==
-see [[Adding References|adding references tutorial]].
 <references />
-[[Category:Vrije_Universiteit_Brussel_Project|Template:VUBTest]]
+[[Category:Vrije_Universiteit_Brussel_Project]][[Category:Musculoskeletal/Orthopaedics|Orthopaedics]][[Category:Knee]][[Category:Special_Tests]][[Category:Assessment]]

Dial Test: Difference between revisions

Revision as of 05:09, 6 October 2014

Contents

Definition/Description[edit | edit source]

Purpose[edit | edit source]

Clinically Relevant Anatomy[edit | edit source]

Technique
[edit | edit source]

Key Research[edit | edit source]

Resources
[edit | edit source]

Evaluation[edit | edit source]

Recent Related Research (from Pubmed)[edit | edit source]

References[edit | edit source]

Physiopedia

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Legal

Dial Test: Difference between revisions

Revision as of 05:09, 6 October 2014

Definition/Description[edit | edit source]

Purpose[edit | edit source]

Clinically Relevant Anatomy[edit | edit source]

Technique[edit | edit source]

Key Research[edit | edit source]

Resources [edit | edit source]

Evaluation[edit | edit source]

Recent Related Research (from Pubmed)[edit | edit source]

References[edit | edit source]

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