title: Joint line fullness and meniscal pathology.
abstract: BACKGROUND
  Meniscal tears have been associated with meniscal cysts and fullness of the knee joint line on physical examination.
  
  
  OBJECTIVE
  Joint line fullness is an accurate, sensitive, and specific test to detect meniscal tears.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  One hundred consecutive patients undergoing knee arthroscopy were included. All had physical examinations documenting the presence of joint line fullness, joint line tenderness, and the McMurray sign. Arthroscopy was the gold standard for tears. Accuracy, sensitivity, and specificity were calculated and correlated with type of tear. Sixty-one patients had a magnetic resonance imaging preoperatively (the gold standard for determining the presence of a cyst).
  
  
  RESULTS
  Meniscal tears were found in 67 patients at arthroscopy. The accuracy, sensitivity, and specificity of joint line fullness were, respectively, 73%, 70%, and 82% in detecting meniscal tears; 68%, 87%, and 30% for joint line tenderness; and 47%, 32%, and 78% for the McMurray sign. The highest positive predictive value for detecting a tear was 88% for joint line fullness, compared with 77% for joint line tenderness and 76% for the McMurray sign. However, joint line fullness did not correlate well with the presence of a cyst, with a low positive predictive value (29%). Of those patients with joint line fullness on physical examination, 89% had a horizontal cleavage component of their tear at arthroscopy.
  
  
  CONCLUSIONS
  Joint line fullness is an accurate, sensitive, and specific test to detect meniscal tears.
  
  
  CONCLUSIONS
  The findings support the routine use of joint line fullness during physical examination along with other common tests to improve the accuracy of clinically diagnosing meniscal tears.
authors.affiliation: McGill University Health Center, Montreal, Quebec, Canada.
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Couture
authors.forename: Wazzan
authors.initials: W
authors.lastname: Al-Juhani
authors.forename: Michael E
authors.initials: ME
authors.lastname: Forsythe
authors.forename: Eric
authors.initials: E
authors.lastname: Lenczner
authors.forename: Robert
authors.initials: R
authors.lastname: Marien
authors.forename: Mark
authors.initials: M
authors.lastname: Burman