Calf Circumference test is an ankle examination procedure that tests for muscle atrophy and acute compartment syndrome.


Patient must be awake and cooperative when the Calf Circumference test is done.

  1. Patient is in a supine lying position while the test is done.
  2. The examiner uses a measuring tape to measure the circumference of the leg at the level of the maximum bulk of the gastrosoleus muscle complex.
  3. The examiner compares the measurement of both lower legs.

Examiner takes measurements of the circumference of both lower legs.


Positive Calf Circumference Test

There is positive Calf Circumference test when there is unequal measurements. This could indicate the presence of muscle atrophy (secondary to internal derangement of the ankle, nerve lesion), increased circumference may indicate the presence of an acute compartment syndrome.

Clinical Notes

There is possible differences in calf circumferences from side to side in elite athletes (dominant versus nondominant). However, this is not typically the case for the general population.

In ankle injuries that cause moderate to severe pain, patients may suffer atrophy from misuse or disuse syndromes. The joint may be too painful to move so patients don’t move the joint and the muscles that control that joint suffer from atrophy.