Which joint has a capsular pattern of flexion greater than extension with a 5:1 ratio?

• A. Hip joint
• B. Talocrural joint
• C. Superior tibiofibular joint
• D. Tibiofemoral joint

Answer: (D)

Capsular patterns show a predictable sequence of motion loss when the joint capsule is involved. For the knee (tibiofemoral joint), flexion is restricted much more than extension, often described as a large disparity—roughly five times greater in flexion loss than extension loss. This reflects how the knee capsule and surrounding structures tighten with swelling or capsulitis, more markedly limiting bending than straightening.

Among the options, the knee fits this pattern best: flexion is notably more limited than extension, representing the 5:1 type ratio described. The hip tends to show greatest restriction in internal rotation, the ankle (talocrural) pattern differs in its primary direction of loss, and the superior tibiofibular joint isn’t typically described with a fixed capsular pattern like this.