Which of the following tests is most appropriate for evaluating meniscal tears?

Which of the following tests is most appropriate for evaluating meniscal tears?

• A. Lachman test
• B. Apley test
• C. Thessaly test
• D. McMurray test

Answer: (D)

Stressing the meniscus by rotating the tibia while the knee is flexed and then extended directly probes for a meniscal tear. In the McMurray maneuver, the knee is fully flexed, the tibia is rotated (externally for the medial meniscus and internally for the lateral), and the knee is then extended. A palpable or audible click or reproducing joint-line pain during this motion strongly suggests a meniscal tear, and the direction of rotation helps localize the involved meniscus. This targeted, reproducible sign makes it the best choice for evaluating suspected meniscal injuries. The Lachman test assesses ACL integrity, not the menisci. The Apley test can indicate meniscal pathology but is less specific and less commonly used as the primary diagnostic maneuver. The Thessaly test is another useful dynamic option but is not as universal or classic as the McMurray test for identifying meniscal tears.

Stressing the meniscus by rotating the tibia while the knee is flexed and then extended directly probes for a meniscal tear. In the McMurray maneuver, the knee is fully flexed, the tibia is rotated (externally for the medial meniscus and internally for the lateral), and the knee is then extended. A palpable or audible click or reproducing joint-line pain during this motion strongly suggests a meniscal tear, and the direction of rotation helps localize the involved meniscus. This targeted, reproducible sign makes it the best choice for evaluating suspected meniscal injuries. The Lachman test assesses ACL integrity, not the menisci. The Apley test can indicate meniscal pathology but is less specific and less commonly used as the primary diagnostic maneuver. The Thessaly test is another useful dynamic option but is not as universal or classic as the McMurray test for identifying meniscal tears.