How is the lever sign test performed?
The patient lies on their back with the legs extended. The examiner places one hand flat over the quads with the other hand made into a fist under the upper third of the calf (acting as a fulcrum).
Downward pressure is applied to the quads with the flat hand. The examiner watches to see if the heel is levered up off the examination table.
If the ligament is intact the heel should lift. If the ligament is torn, the heel should remain on the table.
Initial reports of this test suggested it was very sensitive and specific for tears of the anterior cruciate ligament, but the early findings have not been that reproducible.