Comparison of Three Tests for Meniscal Tear

Most meniscal (knee cartilage) tears occur when the person is standing, putting weight on the leg. However, tests for meniscal tears are all done in a non-weightbearing position. Until now. The Ege's test is a new way to assess the knee meniscus under weightbearing conditions. In this study, the Ege's test was compared to two other standard tests for meniscal tears. The two tests are McMurray's test and joint line tenderness.

Ege's test is done while the patient is standing. The knees are straight and the feet are eight to 10 inches apart. To test the medial meniscus, the patient squats with the feet and legs turned out fully, then stands up slowly. The lateral meniscus is tested by turning the feet and knees in as far as possible.

A positive test occurs when pain or click is felt, and maybe even heard, when the patient bends the knees about 90 degrees.

The knees of 150 patients with symptoms of meniscal injury were tested using the three tests. Afterwards the knees were examined arthroscopically. Anyone who tested positive and also had a torn meniscus during arthroscopic exam had a true positive result.

Here's what the examiners found:

  • All three tests can detect a meniscal tear.
  • Ege's test was more specific, meaning Ege's test is better able to tell when the meniscus isn't torn.
  • A positive Ege's test was linked with a positive arthroscopic exam more often than with the two other tests.
  • More cases of meniscal tear were found with Ege's test compared with joint line tenderness.
  • Ege's test gave similar results to McMurray's test.
  • Ege's test was more accurate with swelling in the knee.
  • McMurray's test was more accurate when there were tears from degenerative problems in the meniscus.

    Ege's test mimics the cause of a torn meniscus and is therefore a more accurate test for this problem. All three tests can be used to diagnose different types of tears. The authors of this report describe each type of meniscal tear and which test is best for each one.

  • Reference: 

    Devrim Akseki, MD, et al. A New Weight-Bearing Meniscal Test and a Comparison with McMurray's Test and Joint Line Tenderness. In Arthroscopy. November 2004. Vol. 20. No. 9. Pp. 951-958.

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