Which knee examination maneuver is used to detect meniscal tears?

Which knee examination maneuver is used to detect meniscal tears?

• A. Pivot-shift test
• B. Lachman test
• C. Apley compression test
• D. Valgus stress test

Answer: (C)

Meniscal tears respond to loading and twisting of the knee, so a test that specifically stresses the meniscus is most informative. The Apley compression test does this by flexing the knee to about 90 degrees, pressing the tibia downward through the heel, and rotating the tibia internally and externally. Reproducing pain, a joint-line click, or locking during the compression suggests a torn meniscus. If distraction of the tibia relieves pain, that points away from a meniscal tear and toward a ligamentous injury. Other maneuvers target ligaments—such as the pivot-shift and Lachman for the ACL, and the valgus stress test for the MCL—so they’re less specific for meniscal pathology.

Meniscal tears respond to loading and twisting of the knee, so a test that specifically stresses the meniscus is most informative. The Apley compression test does this by flexing the knee to about 90 degrees, pressing the tibia downward through the heel, and rotating the tibia internally and externally. Reproducing pain, a joint-line click, or locking during the compression suggests a torn meniscus. If distraction of the tibia relieves pain, that points away from a meniscal tear and toward a ligamentous injury. Other maneuvers target ligaments—such as the pivot-shift and Lachman for the ACL, and the valgus stress test for the MCL—so they’re less specific for meniscal pathology.