Date: 23/11/2020 hours: 4
Today I had a face to face appointment with a patient who I performed an online triage with last-week. The patient has been suffering from pain at the back of the knee (in the hamstrings tendon and popliteal fossa, as well as on the lateralside of the knee). The patient had a history of meniscal tears, so I performed meniscal tests to ensure that this wasn’t causing the pain.
Many tests have been used to assess for the presence of meniscal damage, however the diagnostic accuracy of these tests has been questioned. Here are my notes I made when researching the Meniscal tests, I have saved them in my folder to use with future patients suffering from a suspected meniscal injury.
A study by Konan et al in 2009, examined 109 patients (80 male, 29 female with an average age of 39 years, ranging from 16-56) who were presented with a history suggestive of a meniscal tear. Joint line tenderness, McMurray’s test, and the Thessaly test were assessed for their diagnostic accuracy in identifying meniscal damage. The research showed that joint line tenderness was the most effective test (with a diagnostic accuracy of 81% for medial meniscus and 90% for lateral meniscus). However, diagnostic accuracy could be increased further by using the three tests in conjunction.
It is important to consider the diagnostic accuracy of the tests you choose to use, as using tests with poor specificity and sensitivity could lead to incorrect diagnosis and ineffective treatment, leading to poor rehabilitation outcomes for the patient and risk of re-injury or further injury.
During todays session, before and after my appointment, I researched the different tests using for meniscal damage and Patellofemoral pain syndrome. I assessed their accuracy to ensure I always know and use the most superior test available, when assessing patients, to achieve the most accurate diagnosis.
What I was thinking and feeling and what was good or bad:
I felt really interested and motivated to learn new things and get experience with patients with a variety of injuries.
What else I could have done/areas for improvement:
Continue to keep my knowledge up to date to ensure I have as much knowledge as I can and don’t begin to forget the basic principles.