Understanding the different physical examination tests for suspected meniscal tears.
Meniscal tears are common in sport medicine practice. Many articles and textbooks discuss the relative validity of the different components of the physical examination with respect to their sensitivity, specificity, and positive/negative predictive values as if they were diagnostic tests. In this article, we demonstrate why this approach is limited, including the heterogeneous nature of meniscal tear pathology (e.g., posterior vs anterior). Therefore, in this article, we categorize all the published tests in the literature with regards to the mechanism underlying a positive test. We believe our approach provides the clinician with additional tools to diagnose tears. Future research should explore predictive models based on the different components accounting for heterogeneous pathology and different patient contexts.
Shrier
Ian
I
Centre for Clinical Epidemiology and Community Studies, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Quebec, Canada. ian.shrier@mcgill.ca
Boudier-Revéret
Mathieu
M
Fahmy
Kamal
K
D032882:Comprehension; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis* / Q000628:therapy; D010808:Physical Examination / Q000379:methods* / Q000592:standards; D013178:Sports Medicine / Q000379:methods / Q000592:standards; D000070600:Tibial Meniscus Injuries