This test is indicated in the case of:
- A rotation trauma of the knee.
- Painful passive rotations.
- Joint blockage compression pain during the testing of the collateral ligaments.
With this test, the damaged meniscus is entrapped in the joint. Only posterior horn injuries are detectable, as anterior horn injuries can almost never be entrapped in the joint.
Test For The Medial Meniscus
Procedure
- The patient lies on the examination table in supine position with extended hips and knees.
- Stand on the side of the leg to be tested and bring the knee into 90° flexion.
- Use one hand to take hold of the calcaneus and use the fingers of the other hand to palpate the posterior section of the medial joint space [Figure 85].
Figure 85
- Bring the leg in maximum flexion at the hip and knee and then externally rotate the lower leg.
- From this position, stretch the knee while still palpating the medial joint space [Figure 86].
- Compare left and right.
Figure 86
The test is positive if a painful snap occurs in the knee during the extension of the leg. It is inconclusive if the patient indicates postero-medial joint space tenderness. Crepitations at the postero-medial joint space may indicate a degenerative posterior horn rupture.
A positive test result makes an injury to the medial meniscus likely. However, various investigations have demonstrated that false-negative results occur frequently.
Test For The Lateral meniscus
Procedure
- The patient lies on the examination table in supine position with extended hips and knees.
- Stand on the side of the leg to be tested and bring the knee into 90° flexion.
- With one hand holding the calcaneus, use the fingers of the other hand to palpate the lateral joint space.
- Bring the leg into maximum flexion at the hip and the knee [Figure 85], and then rotate the lower leg inwards.
- From this position, extend the knee while still palpating the lateral joint space [Figure 87].
- Compare left and right.
Figure 87
The test is positive if a painful snap in the knee occurs during the extension of the leg. However, pain without snapping during this manoeuvre can also point to a meniscal injury. Crepitations at the height of the lateral joint space may be indicative of a degenerative posterior horn rupture.
The McMurray test is also performed with valgus and varus stress. There are also various other meniscus tests (Steinmann’s test, Apley’s test, Böhler’s test). However, the reliability of these tests is disputed.