Execution
- 1Ask about anterior or anterolateral ankle pain during weight-bearing dorsiflexion.
- 2Ask about sport history, especially repeated kicking, running, jumping, or cutting.
- 3Palpate the anterolateral ankle joint line for tenderness.
- 4Observe for anterolateral swelling and check for pain with single-leg squat or forced dorsiflexion.
- 5Screen for ankle instability because absence of instability is part of the classic anterolateral impingement rule.
Positive outcome
A positive clinical pattern includes anterolateral ankle tenderness, swelling, pain on forced dorsiflexion, pain with single-leg squat or activities, and absence of ankle instability. Magee lists a six-symptom clinical prediction rule where five of six findings are expected. The pattern supports anterior ankle impingement but does not replace imaging when osteophyte or intra-articular pathology is suspected.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Liu et al. (1997) | clinical examination versus MRI study | NA | NA | NA | NA |
CommentMagee's anterior impingement signs are presented as a clinical prediction rule from Liu rather than one maneuver. The rule fits athletes with chronic anterolateral ankle pain after sprain or repetitive dorsiflexion loading. Because synovitis, osteophytes, instability, and loose bodies can overlap, persistent symptoms may need imaging.
Moderate Clinical Value