Meniscus Tear Notes

Meniscus tear:

Tests:

  1. Joint line tenderness palpation:

Sensitivity = 83%

Specificity = 83%

Most clinical value.

1.Patient laying on back with knee flexed to 90º

    • Patient with knee at 90º makes it possible for us to palpate anterior surface of each meniscus

 

2. Medially rotate tibia in this position – makes medial meniscus more accessible as the femoral condyles push the medial meniscus forwards

 

3.palpate along the joint line and observe patient’s reaction

 

4.Lateral meniscus: rotate the tibia laterally and palpate along joint line

positive test = patients’ pain is reproduced

  1. Apley’s Grind Test:

Statistical accuracy of this test is 58% – meaning only 58% of patients were correctly diagnosed

  1. Patient laying on front
  2. Knee 90 degrees flexion
  3. perform distraction: by pulling leg up
  4. while performing distraction, medially and laterally rotate the leg

Excessive movement = positive test

  1. Then perform compression: by pushing leg down and medially and laterally rotate the leg

Decreased rotation or pain = positive test

Clinical impression:

If rotation + distraction is more painful or shows increased rotation compared to the normal side = more likely to be a ligament problem

If rotation + compression is more painful or shows decreased rotation compared to the normal side = more likely to be meniscus

Thessaly’s

  • Test un-injured side and then injured side
  • Stand on leg and then flex to 20º
  • Rotate 3 times on each side
  • positive if patient complaining of pain in joint line

 

 

 

 

 

 

 

 

 

 

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