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Understanding the Different Physical Examination Tests for Suspected Meniscal Tears

Shrier, Ian; Boudier-Revéret, Mathieu; Fahmy, Kamal

doi: 10.1249/JSR.0b013e3181f2727e
Extremity Conditions: Section Articles

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.

1Centre for Clinical Epidemiology and Community Studies, Lady Davis Institute for Medical Research, Jewish General Hospital, McGill University, Montreal, Quebec, Canada; 2McGill University, Montreal, Quebec, Canada; 3Department of Occupational Medicine and Community Medicine, Alexandria University, Alexandria, Egypt

Address for correspondence: Ian Shrier, M.D., Ph.D., Centre for Clinical Epidemiology and Community Studies, Lady Davis Institute for Medical Research, Jewish General Hospital, 3755 Cote Ste-Catherine Road, Montreal, QC H3T 1E2, Canada (E-mail: ian.shrier@mcgill.ca).

Copyright © 2010 by the American College of Sports Medicine.