Microsoft Test Manager (MTM) picks the language settings from OS. There is no easy way to force MTM to pick alternate settings – say you are using English OS but want MTM be right to left (for example, you are authoring tests in Hebrew).
One workaround to force everything in MTM appear right to left is to set the following registry key.
Windows Registry Editor Version 5.00
To roll back, you need to reset FlowDirection back to 0.
In Right To Left, this is how MTM will look -