Execution
- 1Position the patient sitting or supine with the leg relaxed.
- 2Place both hands around the tibia and fibula at the mid-calf level.
- 3Compress the tibia and fibula together.
- 4Repeat at different levels if needed while avoiding excessive pressure over bruised tissue.
- 5Ask whether pain is referred distally to the syndesmosis region.
Positive outcome
Pain referred distally to the syndesmosis or distal tibiofibular joint is positive. Local calf discomfort at the squeeze site is not a true positive. The test is intended to stress the interosseous membrane and distal tibiofibular syndesmosis.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Hopkinson et al. (1990) | NA | NA | NA | NA | NA |
| Sman et al. (2015) | prospective diagnostic study | 26 | 88 | 2.15 | NA |
CommentSqueeze testing is generally more specific than sensitive for syndesmosis injury, so a positive result is more helpful than a negative one. Magee includes it among syndesmosis stress tests, but the published LR+ is modest. Use it with Kleiger stress, tenderness, and mechanism.
Moderate Clinical Value