Hughston's Plica Test: How to Check for Plica Syndrome

Hughston's Plica Test is a specific manual test used by physiotherapists to identify a symptomatic medial synovial plica in the knee. It attempts to reproduce the "popping" sensation caused by the thickened tissue.

[Image of Hughston's Plica Test]

1. Purpose

The primary purpose of Hughston's Plica Test is to **detect** the presence of a symptomatic medial plica (plica syndrome). A plica is a fold in the synovial membrane of the knee which can become thickened and irritated.

2. How to Perform

1. The patient is positioned in supine (lying on their back) with the knee extended and relaxed.
2. The examiner grasps the patient's foot with one hand and internally rotates the tibia.
3. The examiner places the other hand over the patella, with the fingers palpating the medial femoral condyle.
4. The examiner applies a medial glide to the patella with the heel of the hand.
5. While maintaining internal rotation and the medial patellar glide, the examiner passively flexes and extends the knee.

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
A positive test (indicating plica syndrome) is:

• A palpable "popping" or "clicking" sensation under the examiner's fingers (over the medial femoral condyle) as the thickened plica snaps over the bone.
• This often occurs between 30 and 60 degrees of flexion and may reproduce the patient's pain.

Negative Sign (Test is NEGATIVE):
A negative test is smooth movement without popping, clicking, or pain.