Noble's test is used to detect pathology related to which structure?

• A. Pain or clicking under the lateral knee during knee extension from 90 degrees of flexion.
• B. Pain with resisted knee extension.
• C. Instability of the knee.
• D. Inability to flex the knee.

Answer: (A)

Noble’s test targets the iliotibial band friction syndrome at the lateral knee. The test is performed with the knee bent to 90 degrees, applying pressure just above the lateral femoral epicondyle, then slowly extending the knee. If pain (often around the point of about 30 degrees of flexion) or a snapping sensation develops under the lateral knee as the knee moves from 90 degrees toward extension, this indicates IT band friction over the lateral epicondyle.

This is why the option describing pain or clicking under the lateral knee during extension from 90 degrees of flexion best fits the test’s purpose. The other ideas reflect different issues—pain with resisted extension points to quadriceps or patellar tendon problems, instability refers to ligamentous laxity, and inability to flex suggests ROM limits from other pathology—none of which Noble’s test is designed to detect.