The stutter test, also known as the plica stutter test, is a physical examination technique used to identify potential issues related to the plica, a fold in the synovial membrane of the knee joint.
Understanding the Plica Stutter Test
The test specifically looks for a "stutter" or a jerky movement during knee extension, indicative of a symptomatic plica. Here's a breakdown:
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Patient Positioning: The individual sits with their knees bent, allowing the lower legs to hang freely over the side of an examination couch.
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Palpation: The examiner gently feels the margins of the patella (kneecap).
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Active Extension: The patient actively extends their knee from a flexed position while the examiner continues to palpate around the patella.
What does a positive result mean?
- Stutter or Jerky Motion: A positive test involves feeling or observing a jerky or stuttering motion, often in the mid-range of the knee extension. This suggests that a plica might be catching or interfering with the smooth movement of the knee joint. This is a key indicator that plica inflammation and/or the catching of the plica is occurring during movement.
- Pain: A positive test can also coincide with reports of pain from the patient during the movement.
Why is the test performed?
The plica stutter test is primarily used to determine if symptoms in the knee could be stemming from a plica. The reference mentions a plica test which is an active extension test designed to highlight catching, or 'stuttering' caused by the plica, usually occurring in the mid-range of motion.
The test helps diagnose:
- Plica Syndrome: This condition involves an inflamed or irritated plica, which can lead to pain, clicking, and restricted movement in the knee.
- Differential Diagnosis: It can help rule out other conditions, such as patellofemoral pain syndrome.
Key Aspects of the Test
| Feature | Description |
|---|---|
| Patient Position | Seated with knees flexed over the side of a couch |
| Examiner Action | Palpates around the patella margins |
| Patient Action | Actively extends the knee |
| Positive Finding | Stutter or jerky motion during mid-range extension, possibly with pain. |
| Purpose | To determine the potential for symptomatic plica involvement contributing to knee pain and movement issues |
What to Expect During the Test
- The test is non-invasive and performed as a standard part of a knee examination.
- The test takes only a few minutes to perform.
- If positive, further imaging, such as an MRI, might be needed.
