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When examining a knee for a meniscal injury the commonly described tests are the McMurray Test and Apley Test. However, these tests have sensitivities of 48-68% and 41% respectfully, and specificities of 86-94% and 86-93% respectfully. Depending on whether you are looking at the medical or lateral meniscus.
The Thessaly Test that was first described in 2005 can be performed with knee in either 5 or 20 degrees of flexion and has a senstivity of 89-92% and specificity of 96-97% when performed in 20 degrees flexion. The test also tends to be easier to perform.
To perform the test:
- Stand on affected leg only with the other leg held up in the air. The examiner holds hands for balance.
- Flex knee to be test to 20 degrees, while the other leg is held in the air
- Internally and Externally Rotate Knee
- Positive test is pain at medial or lateral joint line with possible locking/catching sensation
Essentially you and your patient will look like you are doing the twist as they rotate their knee with you holding their hands.
A video of the technique can be found at http://youtu.be/R3oXDvagnic
References
The Journal of Bone and Joint Surgery (American). 2005;87:955-962.