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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The clinical features of a meniscal tear are characteristic:

  • often history of sports related injury with twisting of the knee
  • severe pain such that further movement / games play is immediately prevented
  • if there has been a tear of the medial meniscus, which is more frequent, then the pain is localized to the anteromedial joint line; the pain that occurs with a lateral tear is far more diffuse
  • knee may 'lock out'
  • swelling around knee appears some hours, or even days, after the injury
  • initial symptoms are relieved by rest; symptoms reappear after trivial twists or strains of the knee

Signs:

  • the knee may be held slightly flexed
  • an effusion may be present
  • localized tenderness over the medial joint is typical of a medial meniscus tear; tenderness on the lateral side is less well-localized;
  • extension is often limited; flexion is generally not reduced
  • McMurray's or Apley's grinding test may be positive
  • Thessaly test at 20 degrees flexion is accurate in the detection of meniscal tears (1)
  • quadriceps muscle will be wasted in long-standing cases

Between attacks the knee may be surprisingly asymptomatic.

Reference:

  1. Karachalios T et al. Diagnostic accuracy of a new clinical test (the Thessaly test) for early detection of meniscal tears. J Bone Joint Surg Am 2005;87:955-62

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