Anatomy and physical examination of the knee menisci: a narrative review of the orthopedic literature.
OBJECTIVE
The objective of this study was to review the physical examination tests available to a practitioner in order to arrive at a clinical diagnosis or suspicion of a meniscal lesion.


BACKGROUND
The menisci transmit weight bearing forces and increase stability of the knee. The menisci also facilitate nutrition, provide lubrication and shock absorption for the articular cartilage and promote knee proprioception. The combinations of torsional and axial loading appear to be the cause of most meniscal injuries. Diagnosis of acute knee injuries has long been a topic for discussion throughout the orthopedic literature. Many clinical tests and diagnostic studies have been developed to increase the clinician's ability to accurately diagnose these types of disorders of the knee.


CONCLUSIONS
The accuracy of all diagnostic tests is thought to be dependant upon the skill of the examiner, and the severity and location of the injury. The multitude of tests described to assess meniscal lesions suggests that none are consistently reliable. However, recent research has focused on a composite score to accurately predict meniscus lesions. The combination of a comprehensive history, multiple physical tests and diagnostic imaging for confirmation is typical for a clinical meniscal lesion diagnosis while the gold standard remains the arthroscopic procedure itself.
Chivers
Michael D
MD
Assistant Professor, Clinical Education, Canadian Memorial Chiropractic College, Toronto, Canada.
Howitt
Scott D
SD