American Board of Internal Medicine (ABIM) Certification Practice Exam

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What is the purpose of the Noble maneuver?

Testing for patellar tendinitis
Assessing meniscal injuries
Evaluating iliotibial band integrity
Measuring range of motion

The correct answer is: Evaluating iliotibial band integrity

The Noble maneuver is specifically designed to evaluate the integrity of the iliotibial band (ITB) and its relationship to lateral knee pain, often associated with conditions like iliotibial band syndrome. During the maneuver, the examiner flexes and extends the knee while applying pressure over the lateral femoral epicondyle. A positive test is indicated by pain over the lateral aspect of the knee, typically due to friction between the ITB and the femoral condyle, which occurs as the knee transitions from flexion to extension. This maneuver is distinct from other assessments like testing for patellar tendinitis, assessing meniscal injuries, or measuring range of motion, which involve different techniques and focus on different structures within the knee. While each of those aspects is important in a comprehensive knee examination, the Noble maneuver specifically targets the iliotibial band and its potential pathologies.