Trokos

Test library › Foot, ankle & calf

Anterior drawer test (ankle)

For: Lateral ligament (ATFL) injury

A sprain or tear of the anterior talofibular ligament (ATFL) on the outside of the ankle, the ligament most often injured when the ankle rolls over with the sole turning inwards.

A weak test on its own
Sensitivity54%
Specificity87%
LR+ (positive)3.97
LR− (negative)0.54

Likelihood ratios as published by the review from its pooled statistical model, so they differ slightly from ratios of the rounded sensitivity and specificity.

What the numbers mean

  • Positive result: a small shift: a positive result nudges the diagnosis up, but does not settle it.
  • Negative result: barely informative: a negative result changes little.

Work out what a result means for your patient: probability calculator

Source

Netterström-Wedin F, Matthews M, Bleakley C. Diagnostic Accuracy of Clinical Tests Assessing Ligamentous Injury of the Talocrural and Subtalar Joints: A Systematic Review With Meta-Analysis. Sports Health. 2022;14(3):336–347. Journal article · meta-analysis

Figures as they will appear in Rule It In, Rule It Out (Trokos, forthcoming). If a newer or better study changes them, this page changes with the book. Figures last updated from the book on 6 October 2026.

Get the book for spotting a high ankle sprain, and knowing when the Achilles is torn

This page gives the published figures. Rule It In, Rule It Out adds how to do this test, what counts as positive, how to read the result, and, where studied, whether combining it with other tests helps.

Coming in late 2026 as a PDF and a paperback. Join the list to hear when it's out

One study, one test, once a month

Rule It In is a free evidence letter for musculoskeletal clinicians: one recent study explained, one examination test with its real numbers. From Trokos, publisher of Rule It In, Rule It Out.