04 Knee Special Tests: Meniscus Flashcards Preview

7232 Ortho > 04 Knee Special Tests: Meniscus > Flashcards

Flashcards in 04 Knee Special Tests: Meniscus Deck (18):

clusters of s/s for meniscus tests?

- history of macrotrauma
- twisting MOI
- delayed effusion
- reproducible click/clunk
- pseudolocking
- joint line pain


How do older people commonly get a twisting MOI?

- can just go from kneeling to standing
- normal screw home mechanism of the tibia


delayed effusion time

over 12 hours


What else does the recurvatum test assess aside from the PCL?

anterior horns of the meniscus


What does Steinman's test assess?

posterior horns of the meniscus


How to do Steinman's test

- flex hip to 90˚
- slowly flex knee
- proximal hand palpates medial/lateral joint line
- distal hand at ankle
- 3 overpressures


What is McMurray's test?

- end position of Steinman's test
- take distal hand and put under heel
- internally and externally rotate tibia 3x


What is McMurray's test assessing?

posterior horns of meniscus


What is a positive Steinman's or McMurray's test?

- pain on joint line palpation
- 95% positive predictive value for meniscus tear


What does the dynamic McMurray's test assess?

entire meniscus
- posterior horns
- middle
- anterior horns


dynamic McMurray's test: part 1

- hand on heel, forearm on medial side of foot to ER tibia
- give valgus force on lateral femoral epicondyle, fingers to ceiling
- move knee from flexion to extension
- don't let hip go into IR


dynamic McMurray's test: part 2

- hand on heel, forearm on lateral side of foot to IR
- varus force to medial side of knee
- move from flexion to extension
- hand under posteromedial portion of knee to prevent bounce


What does the Apley's compression test assess?

posterior horns of meniscus


Apley's compression position

- prone
- flex knee to 90˚
- hands on heel
- give axial compressive loading while internally and externally rotating tibia


positive Apley's compression test

- replication of joint line pain
- snapping
- cracking
- clicking, clunking, pseudocatching, locking


What does the Apley's dynamic compression (DDV) assess?

entire meniscus


What do you need to remember before performing the Apley's dynamic compression (DDV)?

put a towel or pillow under the distal femur so patella isn't being crushed on the table


positioning for the Apley's dynamic compression (DDV)

- prone
- knee flexed to 90˚
- compress, externally rotate, and take knee to full extension 3x
- repeat with internal rotation