Meniscal Tests?as accurate as MRI!!

Reference:Muellner T et al. 1997 The diagnosis of meniscal tears in athlete?s; A comparison of clinical and MRI investigations. American Journal of Sports Medicine (25):1;7-12

Magnetic resonance imaging (MRI) is considered to be a ?gold standard? test for diagnosing meniscal lesions, however it is not easily accessible, it is expensive and usually involves being on a long waiting list.

This study supported that taking a good history and using a group of tests to stress the meniscus may be as accurate, sensitive and specific as MRI.

——–Clinical Testing ——-MRI
Accuracy:—-94.5%——–95.5%
Sensitivity:—-96.5%——98%
Specificity:—-87%——–85.5%

The testing consisted of all the 6 tests outlined below: (monitoring for symptom reproduction of pain or ?clicking?)

 

  • Test #1: Joint Line Tenderness
    Simply palpate the anterior and posterior tibio-femoral joint.
  • Test #2: McMurray?s Test
    Medial and lateral rotation of the tibia performed in various stages of knee flexion.
  • Test #3: Apley?s Test
    With the patient in prone and the hip extended to neutral-flex the knee >90� and then rotate and compress the tibia.
  • Test #4: Bohler?s Test
    Same technique as when testing for the collaterals but we are concerned with the compressive aspect of this test.
  • Test #5: Steinman?s Test
    Sitting with knee hanging over the exam bed; medial and lateral rotation of the tibia in performed.
  • Test #6: Pary?s Test
    Flex the knee to 90� and apply a varus stress-this compresses the medial meniscus posterior horn.
    Posted on: February 19, 2002

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