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Foot, ankle and calf special tests quiz

Questions use only the figures on this library's test pages.

Last updated 30 October 2026. 8 questions. Each answer links to the test page it comes from; the region's tests are listed on the Foot, ankle & calf cheat sheet.

Terms such as sensitivity, specificity, LR+ and LR− are explained in the glossary. A likelihood ratio above about 5 or below about 0.2 is doing real work; between 2 and 0.5 it is barely worth the time.

Question 1 of 8

Which of these tests best rules out syndesmosis (high ankle) sprain?

  1. Unable to perform single-leg hop
  2. Syndesmosis ligament tenderness (palpation)
  3. Squeeze test (syndesmosis)
  4. Dorsiflexion–external rotation test
Show the answer

Answer: B. Syndesmosis ligament tenderness (palpation). Syndesmosis ligament tenderness (palpation) has the lowest LR−, 0.28. The others: Unable to perform single-leg hop 0.37, Dorsiflexion–external rotation test 0.46, Squeeze test (syndesmosis) 0.84. Even so, its page calls a negative result a small shift: “a negative result nudges the diagnosis down, but does not exclude it.” See the test

Question 2 of 8

How far does a negative probe-to-bone test move the probability of osteomyelitis under a diabetic foot ulcer?

  1. Down clearly: it is doing real work (LR− below about 0.2)
  2. Down a little: a small shift (LR− between about 0.2 and 0.5)
  3. Barely: it is barely worth the time (LR− above about 0.5)
  4. Up: a negative result makes it more likely
Show the answer

Answer: A. Down clearly: it is doing real work (LR− below about 0.2). Probe-to-bone test (diabetic foot ulcer): LR− 0.16. Its page: “a moderate rule-out: a negative result makes the diagnosis clearly less likely.” See the test

Question 3 of 8

How far does positive syndesmosis ligament tenderness move the probability of syndesmosis (high ankle) sprain?

  1. Up clearly: it is doing real work (LR+ above about 5)
  2. Up a little: a small shift (LR+ between about 2 and 5)
  3. Barely: it is barely worth the time (LR+ below about 2)
  4. Down: a positive result makes it less likely
Show the answer

Answer: C. Barely: it is barely worth the time (LR+ below about 2). Syndesmosis ligament tenderness (palpation): LR+ 1.3. Its page: “barely informative: a positive result changes little.” See the test

Question 4 of 8

How far does a positive anterior drawer test (ankle) move the probability of lateral ligament (ATFL) injury?

  1. Up clearly: it is doing real work (LR+ above about 5)
  2. Up a little: a small shift (LR+ between about 2 and 5)
  3. Barely: it is barely worth the time (LR+ below about 2)
  4. Down: a positive result makes it less likely
Show the answer

Answer: B. Up a little: a small shift (LR+ between about 2 and 5). Anterior drawer test (ankle): LR+ 3.97. Its page: “a small shift: a positive result nudges the diagnosis up, but does not settle it.” See the test

Question 5 of 8

What counts as a positive squeeze test (syndesmosis)?

  1. Tenderness over the ligament.
  2. Pain felt distally at the syndesmosis rather than at the site of compression.
  3. Absence of plantarflexion of the foot when the calf is squeezed.
  4. Inability or unwillingness to hop because of pain.
Show the answer

Answer: B. Pain felt distally at the syndesmosis rather than at the site of compression. The Squeeze test (syndesmosis) page: “Pain felt distally at the syndesmosis rather than at the site of compression.” See the test

Question 6 of 8

What counts as a positive Royal London Hospital test?

  1. Disappearance or clear reduction of the tenderness in dorsiflexion.
  2. Reproduction of the familiar plantar heel pain as the fascia tightens.
  3. Absence of plantarflexion of the foot when the calf is squeezed.
  4. A palpable gap or defect, usually 2–6 cm above the insertion.
Show the answer

Answer: A. Disappearance or clear reduction of the tenderness in dorsiflexion. The Royal London Hospital test page: “Disappearance or clear reduction of the tenderness in dorsiflexion.” See the test

Question 7 of 8

Starting at 30% for osteomyelitis under a diabetic foot ulcer, what is the probability after a positive probe-to-bone test?

  1. 6%
  2. 69%
  3. 48%
  4. 85%
Show the answer

Answer: B. 69%. From the ladder on the Probe-to-bone test (diabetic foot ulcer) page: a starting 30% becomes 69% after a positive (LR+ 5.12: a moderate rule-in). See the test

Question 8 of 8

Starting at 30% for lateral ligament (ATFL) injury, what is the probability after a positive anterior drawer test (ankle)?

  1. 19%
  2. 45%
  3. 63%
  4. 74%
Show the answer

Answer: C. 63%. From the ladder on the Anterior drawer test (ankle) page: a starting 30% becomes 63% after a positive (LR+ 3.97: a small shift). See the test

Other quizzes: Shoulder · Knee · Neck · Low back & pelvis · Hip, groin & thigh · Elbow & forearm · Wrist & hand. How the figures are chosen: Methods.

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