Ankle & Foot
Bone, Fracture & Joint Pathology
Evidence: suggestive
Tuning Fork Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Screening for Stress Fractures (e.g., Tibia, Fibula, Metatarsals).
How to Perform
- Action: Strike a tuning fork (128 Hz or 256 Hz) to make it vibrate.
- Placement: Place the base of the vibrating fork directly onto the bone at the site of suspected fracture.
Interpretation of Results
- Positive Test: Sharp, sudden increase in pain at the fracture site.
- Note: If pain is absent, a stress fracture is less likely, but X-ray/MRI may still be needed.
Diagnostic Accuracy
- Sensitivity: Variable; good for ruling out fractures when negative.
Clinical Context & Limitations
The Tuning Fork 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 Ankle & Foot region, combining the Tuning Fork Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment (7th ed.). Elsevier.
