Examination method of meniscus injury-clinician

Examination methods of meniscus injury:

1. Tenderness site: Tenderness site is generally the lesion site, which is of great significance for the diagnosis and judgment of meniscus injury. During the examination, the knee joint was placed in a semi-flexion position, and the upper edge of the tibial condyle (that is, the meniscus edge) was pressed point by point with the thumb from front to back, and there was fixed tenderness at the meniscus injury. If the knee is passively flexed and stretched or the calf rotates inside and outside when pressed, the pain is more obvious, and sometimes the abnormal meniscus can be touched;

2. mcmurry test (rotary extrusion test): The patient lies on his back, and the examiner holds the ankle joint of the calf with one hand and the knee joint with the other hand to bend the hip and knee as much as possible, and then makes the calf abduction, external rotation, abduction and internal rotation, or adduction and external rotation, and gradually straighten. If there is pain or noise, it is positive, and the damaged part is determined according to the pain and noise parts;

3. Strong hyperextension or hyperflexion test: passive hyperextension or hyperflexion of knee joint, such as anterior meniscus injury, can cause pain; For example, posterior meniscus injury, flexion can cause pain;

4. Lateral pressure test: the knee joint is in a straight position, and the knee joint is passively adducted or abducted. If there is meniscus injury, it will squeeze the affected joint space and cause pain;

5. One-leg squat test: one leg gradually squats from the standing position and then stands up from the squatting position. The healthy side is normal. When the affected side squats or stands up to a certain position, the injured meniscus is squeezed, which may cause joint space pain, and even it is impossible to squat or stand up;

6. Gravity test: The patient takes the lateral position, lifts the lower limbs to actively flex and extend the knee joint, and when the joint gap on the affected side is downward, it squeezes the injured meniscus, causing pain. On the contrary, there is no pain when the joint space on the affected side is upward;

7. Grinding test: The patient takes a prone position, the knee joint flexes, and the examiner holds the ankle with both hands and presses the calf, while doing internal and external rotation. The injured meniscus is painful from squeezing and grinding. On the contrary, if the calf is lifted up and then rotated inside and outside, there is no pain;

8.X-ray examination: The frontal X-ray film can not show meniscus injury, but it can exclude other bone and joint diseases. Knee arthrography is of little significance for diagnosis, which can increase the pain of patients and is not suitable for use.

9. Knee arthroscopy: The position and type of meniscus injury and other structures in the joint can be directly observed through arthroscopy, which is helpful for the diagnosis of difficult cases.