Execution
- 1Position the patient supine or side-lying with the knee flexed to about 90 degrees.
- 2Place a thumb or fingers over the lateral femoral epicondyle.
- 3Apply firm pressure over the iliotibial band at the lateral epicondyle.
- 4Passively extend the knee from flexion toward extension while maintaining pressure.
- 5Note whether lateral knee pain occurs around 30 degrees knee flexion.
Positive outcome
Sharp pain over the lateral femoral epicondyle at approximately 30 degrees of knee flexion is positive. The test suggests iliotibial band friction syndrome. Diffuse lateral knee pain or joint-line pain should be differentiated from LCL or lateral meniscus pathology.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Noble (1980) | NA | NA | NA | NA | NA |
CommentNoble's test is commonly taught for ITBS, but robust diagnostic-accuracy literature is limited. The 30-degree pain arc fits the proposed friction/compression mechanism over the lateral femoral epicondyle. Use it with running history, tenderness, and load behavior.
Low Clinical Value