The best way to diagnose this condition is to see your doctor as soon as possible for a physical examination of your knee. Other than meniscus injuries, there are other conditions that can cause knee pain, like ACL (Anterior cruciate ligament) tears, quadriceps tendinitis or patella tendinitis, and a fracture, arthritis, or knee bursitis. It is important to get a proper diagnosis so that you can properly treat your condition. Knowing what kind of meniscus injury you are suffering from is the key to your healing.
Your doctor will begin with a medical history and will also ask about your current situation and your symptoms. This will help your doctor get a proper diagnosis. Your pain intensity, how long you've had your symptoms, and limitations you are experiencing. It is important to know the details of your injury, including when it started and whether or not you have ever had treatment (for this or a similar condition in the past) are very beneficial in finding your injury.
General Physical Exam To Diagnose Meniscus Tears
Meniscus tears can be divided into two groups those with locking and those without locking. If your knee joint is locked, the diagnosis of meniscus damage is pretty straightforward. However, it is more difficult to diagnose if the knee joint is not locked.
Common Physical Exam
There will be a physical examination to determine whether you have any symptoms of a meniscus tear or possibly another knee injury. To evaluate the symmetry and to explore any difference, your doctor will visually evaluate and synergy (feel) of both the knees and around the bones and soft tissues. This will reveal abnormalities like inflammation, bone deformity, and atrophied muscle. A doctor will press down on your injured knee joint to check for tenderness. This will help to determine the exact location of the injury.
A doctor may ask you to perform a series of knee and leg movements, like moving your knee from a straight to flex position or turning your knee so that you can see which motions are causing pain, instability, weakness and grinding, popping, catching, or locking. Your knee will also be examined for swelling, fluid, and heat.
It is essential to ensure that no single test is not enough to install a 100% precise diagnosis of meniscus damage. Test results can be less reliable in cases of tears that are degenerative or where ligament tears cause additional damage example ACL, MCL.
McMurray's Test
McMurray's Tests are performed when you lay down your back. The doctor will place one hand on your knee and the other on your ankle. The doctor will raise your knee slightly and flex it at a 45-degree angle. The doctor will feel the medial line of your knee joint while you pull your leg towards the doctor and rotate your knee. Then the knee is moved at an angle of 90-degrees from full flexion (straight). If there is a clicking sound during this movement, it means that you have a meniscus tear.
Joint Line Tenderness Test
Simply apply pressure to the meniscus while lying flat on your back. This will test for tenderness in the joint line. If there is an ache, the test is positive.
Apley Grind Test
If there is a pain when bending the knee to 90 degrees and rotating the leg inwardly and outwardly is felt during an Apley Grind Test, it would indicate a positive result. Apart from this, the lower foot is pulled out from the knee joint (distraction) and is pushed towards the knee joint (compression). If the pain becomes faster during compression, it is believed that there is a meniscal injury.
Ege's Test
An Ege's test is conducted while standing and putting weight on your knees. You start by standing with your feet 8-10 inches separated. For lateral meniscus testing, the doctor will ask that you extend your knees and feet as much as you can. Medial meniscus tests require you to stretch your legs and feet fully. Once you get the right situation, you will sit slowly and then stand slowly. When your knees reach about 90 degrees, you feel pain, or if a clicking sensation (you can hear it), the test is assumed positive, and a meniscus tear is suspected.
Thessaly Test
A Thessaly test is conducted as follows. The patient stands on one leg, flatfooted, with the knee little flexed about 5 degrees while holding an object or the examiner to maintain balance. The patient would then turn inwardly and outwardly three times, putting rotational pressure on his knee joint. The patient would then continue this rotation, but with his knee bent further (20 degrees).
The Thessaly test is assumed to be positive if there are mechanical signs like popping and latching etc. And medial or lateral joint line discomfort, pain manifesting horizontally along the seam of the knee joint - medial = inner knee, lateral = outer knee.