Valgus Stress Test (of the knee)

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Patient Position

  • Supine (or seated)

Procedure Steps

Supine testing

  • Stand to the outside of the patient.
  • Drop the leg off the table and flex the knee to 30°.
  • Put fingers of proximal hand over the medial joint line.
  • Place your hip against the lateral knee and use it as a fulcrum to apply a valgus force at the knee (distal hand at the foot/ankle).
  • Compare to the opposite, unaffected side.

Seated testing

  • Flex the involved knee to 30°
  • Support the medial ankle with one hand
  • Apply a valgus force (lateral to medial) at the knee – check for pain
  • Put your fingers along the medial joint line while applying the force to feel for gapping or a soft end-feel
  • Compare to the opposite, unaffected side.

Positive Sign / Significance

  • Significantly increased medial joint space gapping (compared to other side) = Medial collateral ligament tear (grade 3 complete tear)
  • Increased medial knee pain with valgus pressure = MCL sprain

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