How to judge meniscus injury

Hyperextension test: the knee joint is completely straight, and when it is slightly hyperextension, the meniscus is pulled or squeezed to rupture, resulting in severe pain.

Postflexion test: the knee joint is extremely flexed, and the broken posterior horn is stuck, resulting in severe pain.

Meniscus rotation test: supine, the affected hip and knee joint fully flexed. The examiner puts one hand on the outer joint space for palpation, and then holds the heel with the other hand for a wide range of circular motion of the calf. The medial rotation tests the lateral meniscus, and the lateral rotation tests the medial meniscus. While maintaining the rotation posture, the knee joint is gradually extended to 90 degrees, and pay attention to the joint angle when the noise occurs. If the joint touches the sound in the fully flexed position, it means that the posterior horn of meniscus is damaged. When the joint is stretched to about 90 degrees, it will make a sound of physical injury, and then gradually straighten to the slightly flexed position while maintaining the rotation position (Mouche test). At this time, touching the sound suggests that the anterior horn of meniscus may be damaged.

Grinding test

In prone position, the knee joint is bent at 90 degrees, and the examiner presses the calf hard to do internal rotation and external rotation, so that the joint surface of femur and tibia is rubbed. If external rotation causes pain, it indicates lateral meniscus injury. After that, lift the calf and do internal rotation and external rotation. If external rotation causes pain, it indicates that the medial collateral ligament is injured. This test has certain practical significance for examining the meniscus of patients with hip ankylosis.

Squat walking test:

It is mainly used to check whether the posterior horn of meniscus is damaged. The method is as follows: ask the patient to squat, take duck steps, and change direction from time to time, or left or right. If the patient can complete these movements well, the injury of the posterior horn of meniscus can be ruled out. If the knee joint can not fully flex due to pain, it is a positive result, and the murmur in the posterior corner of the meniscus is obvious when squatting. This experiment is only suitable for checking adolescent patients, especially for large-scale physical examination.

accessory examination

X line

Orthographic film of knee joint is of great significance for differential diagnosis, which can exclude osteochondral injury, intra-articular loose bodies and bone tumors, and is also of great significance for deciding whether to operate. For example, arthroscopic surgery is generally not suitable for patients with severe osteoarthritis.

CT examination

Its role in the diagnosis of meniscus tear is limited and its accuracy is low, so it has been replaced by MRI. Meniscus tear showed the changes of morphology and density on CT. One or more irregular linear low density areas appear at the tear.

zeugmatography

When the linear high signal in the meniscus reaches its free edge or articular surface, it can be diagnosed as meniscus tear. According to the relationship between the degree of abnormal signal changes in meniscus and pathological changes, abnormal meniscus degeneration and tear in MRI images can be divided into three signal levels. Generally, the third-order signal change can be regarded as fibrocartilage rupture in pathology. Therefore, if we see a third-order signal on a segment of the meniscus, accompanied by irregular shape, we can diagnose meniscus tear.

Arthroscopy

Arthroscopy can be performed when meniscus injury is highly suspected in clinic and cannot be diagnosed or ruled out by physical examination and auxiliary examination. In recent years, arthroscopy has developed from simple diagnosis to both diagnosis and treatment, and it can treat the diseased meniscus while arthroscopic exploration.

It must be noted that any examination is not the only basis for the diagnosis of meniscus injury of knee joint, and the final diagnosis can be made only by combining clinical symptoms, tenderness points and various positive results. The imaging examination of meniscus injury is mainly MRI, which can reach 90%.