Knee
Other Tests
Evidence: suggestive
Fluctuation Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Detecting Large Knee Effusion.
How to Perform
- Action: Examiner places one hand on the suprapatellar pouch and the other on the anterior knee joint.
- Technique: Press down with one hand and feel for fluid displacement (fluctuation) under the other hand.
Interpretation of Results
- Positive Test: Fluid is felt moving back and forth between the hands.
Clinical Context & Limitations
The Fluctuation Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Knee region, combining the Fluctuation Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
