Meniscal injury tests – Mc’murray’s tests, Apley’s grinding test, Thessaly test, Squat test. All positive and negative findings.
We have discussed four tests :
- Mc’Murray’s Test
- Apley’s grinding test
- Thessaly test
- Eges test
I. Mc’Murray’s test :
1. Purpose –
McMurray’s test is done to see if a meniscal tear is present in the knee.
Dianostic accuracy – 63 %
2. Procedure –
- The patient is said to lie-down in supine position, with the knee fully flexed.
- The clinician bring the knee into extension by rotating the tibia medially.
- To test the lateral meniscus – we must repeat the process at various angles of knee flexion to evaluate the entire post aspect of the lateral meniscus.
- To test the medial meniscus – the examiner bends the knee and rotates the tibia laterally.
3. Clinical findings –
Positive findings :
If the patient experience any clicking, locking or pain in the knee during the examination, then it is said to be positive test.
II. Apley’s grinding test :
1. Purpose :
To examine the integrity of the knee’s collateral ligaments.
2. Procedure :
- Patient is told to lie-down in supine position.
- The examiners should fix his/her own leg to the test leg.
- Then we bring the patient’s knee into 90 degree flexion.
- Simultaneously during giving the traction, we have to perform lateral and medial rotation of the tibia.
- Then we have to repeat the same procedure during giving compression to check the discomfort and decreased rotation.
3. Clinical findings :
Positive findings :
- Ligamentous Damage – If the rotation and distraction is more painful or shows increased rotation relative to normal side.
- Meniscal Damage – If the rotation and compression is more painful or shows decreased rotation relative to the normal side.
III. Thessaly test :
1. Purpose :
Meniscal tears/lesions can be detected with this clinical screening method.
- Patients with suspected meniscal tears complain of pain along the medial or lateral joint lines, as well as a feeling of locking or catching.
- The Thessaly test is a dynamic simulation of joint loading in the knee, with the idea that a knee with a meniscal tear will generate the same symptoms as the patient.
2. Procedure :
- At first we have to check the normal or uninjured leg.
- Then after checking the normal leg we will move towards the injured leg.
- The patient should stand on the injured leg which is flexed to 20 degree.
- The examiner may hold onto the patients arms for the support.
- The we have to rotate over the tibia three times on each sides.
3. Clinical findings :
Positive findings :
This test is said to be positive if the patient complaining about the pain in the joint line during the rotation.
IV. Weight bearing Mc’Muray’s Test/Eges Test :
1. Purpose :
- The goal of the test is to find out if the meniscus is torn.
- It’s also known as the weight-bearing McMurray test since patients must bear weight on their knees throughout the test.
- The patient’s feet are turned outwards (medial meniscus) or inwards (inferior meniscus) depending on which meniscus we’re looking at (lateral meniscus).
2. Procedure :
- At first the patient is said to stand with fully extended knees and both feet 30-40cm apart.
- Then to detect a Medial meniscus tear the patient is asked to squat with both legs in maximal external rotation.Then say the patient to stand up slowly. As the squatting proȩedsm, the distance between the knees increases and each knee becomes externally rotated.
- To detect the Lateral meniscus tear – The patient are told to held the both lower extremities in maximum rotation while he/she squats and stands up.
3. Clinical findings :
Positive findings :
If any pain and click is felt by the patient at the related site of the joint line, then it is said to be positive test.