The patellar tilt test assesses the amount of patellar tilt which can be elicited by an examiner, and gives an idea of the tightness of the retinaculum on each side of the patella.

patellar tilt test
Position of the fingers for the patellar tilt test.

 

How to perform the patellar tilt test

The test is performed in the following manner -

  • the patient lies on his/her back with the knee stretched out on the examination couch. The toes should be pointing straight up but the muscles must be relaxed with the joint at about twenty degrees of flexion (bent to 20 degrees).
  • normally the patella lies parallel to the horizontal or the outer edge may be tilted up a little (less than 10 degrees).
  • standing at the end of the examination couch, an examiner tries to lift up the outside edge of the patella (kneecap) using his thumb. The patella should not be pushed to the inside or the outside. Usually the outer (lateral) edge of the patella can thereby be tilted up about 20 degrees above the horizontal.
  • if the lateral retinaculum is tight, the examiner may not be able to lift it up at all and the tilt test offers zero degrees of tilt. In such a situation the resting tilt may be zero or negative.
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Differential diagnosis of patellofemoral pain

Part 3 of a course on Patellofemoral Pain by Dr Ronald Grelsamer of Mount Sinai Hospital in New York.

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CLINICAL PUBLICATIONS

Illustration of patellar tilt test. Orthop J Sports Med. 2017 Mar; 5(3): 2325967116689465.


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