clinical features
Last reviewed 03/2023
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: