Clinical tests for meniscal tear, compared
A tear in a meniscus, one of the two C-shaped cartilage pads between the thigh bone and the shin bone. Can follow a twist or develop with age.
The 4 tests in the library for meniscal tear, side by side, each with the published accuracy figures that exist for it. Click a test for what each result means, any caution, and the source.
| Test | Sensitivity | Specificity | LR+ | LR− | Verdict |
|---|---|---|---|---|---|
| Apley's grind/compression test | 22% | 88% | 1.83 | 0.89 | A weak test on its own |
| Joint line tenderness | 76% | 77% | 3.3 | 0.31 | A weak test on its own |
| McMurray's test | 70% | 71% | 2.4 | 0.42 | A weak test on its own |
| Thessaly test (20° flexion) | 75% | 87% | 5.6 | 0.28 | Treat with caution |
Reading the table
A high LR+ makes a positive result useful for ruling the condition in; a low LR− makes a negative result useful for ruling it out. A test can be good in one direction and weak in the other, and the figures come from different studies and patient groups, so compare them with care.
No single test settles this, and no validated cluster figures exist for the meniscus.
Tests for the same problem are rarely independent, so a second positive adds much less than its own figure suggests. Do not multiply their figures together.
To turn a figure into a probability for your patient, use the probability calculator.
Get the book for how to do and read each knee test with published figures, and which ones to trust for the ACL, meniscus and kneecap
This page gives the published figures. Rule It In, Rule It Out adds how to do each test, what counts as positive, how to read the result, and, where studied, whether combining tests helps.
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One study, one test, once a month
Rule It In is a free evidence letter for musculoskeletal clinicians: one recent study explained, one examination test with its real numbers. From Trokos, publisher of Rule It In, Rule It Out.
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