The stutter test is a test for the presence of a symptomatic medial synovial plica in the knee.

Page updated November 2023 by Dr Sheila Strover (Clinical Editor)

site of pain from a synovial plica on the medial side of the knee
The jagged mark on the image is where examiner places the finger to feel for a stutter as the knee is actively bent and straightened.

 

What is a medial synovial plica?

A plica in the knee is an embryonic remnant of synovium - the thin tissue-like lining of the knee joint, and it is a normal anatomical structure.

The one that is present on the medial side of the knee, not in everyone, but quite commonly, is called the medial plica. It is also known as the medial synovial shelf, stretching along the side of the rounded condyles of the femur, where it can become nipped by the joint during movement.

Back to top

 

What is the plica syndrome?

Plica syndrome is simply pain in the front of the knee caused by the impingement between adjacent knee tissues of an inflamed or thickened synovial plica.

 

Back to top

 

How to perform the stutter test for a medial plica

The patient sits on the edge of the examination couch with both legs hanging over the edge at 90 degrees. The examiner sits to the one side of the knee and places a finger over the medial side of the knee. The patient is asked to slowly straighten the knee and the examiner feels for a 'stutter' in the joint at about 45-60 degrees of flexion. This is the position where an enlarged plica might impinge between the femur and the patella.

  • Quote from peer-reviewed paper:

    "Two physical exam techniques can suggest plica syndrome. These tests are the Stutter test and the Hughston test. When both tests are positive, the diagnosis of plica syndrome should be suspected. If only 1 of the 2 is positive, plica syndrome is less suspicious, but should still be considered."

    Citation: Casadei K, Kiel J. Plica Syndrome. [Updated 2023 Apr 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK535362/

Back to top

 

What causes the stutter?

medial plica of the knee

An enlarged medial plica may get compressed between the femur and the contracting quadriceps muscle, with intermittent painful muscle spasm causing the stuttering of the quads.

Back to top

 

-

Dr Sheila Strover (Editor)
BSc (Hons), MB BCh, MBA

See biography...

Advertisement


Relevant material -


eBook about synovial plica

eBook download - An overview of plica problems in the knee

by Dr Lars Blønd (Knee Surgeon). Free to download.