Meniscal tear: The Daily PANCE Blueprint
A 38-year-old man comes to the office due to left knee pain for the past 4 days. He twisted his knee while playing soccer and felt a sharp pain immediately but was able to continue playing. The next morning, he noticed swelling in the knee and significant pain on the medial side of the knee, especially with stairs and squatting. He is able to fully extend the knee but experiences a catching sensation when walking, and the pain is interfering with his daily activities. Which of the following is most likely to be found on examination of this patient’s knee?
A. Positive Lachman test
B. Positive McMurray test
C. Positive patellar apprehension test
D. Positive anterior drawer test
E. Positive varus stress test
Answer and topic summary
The answer is Positive McMurray test
The most likely finding on examination of this patient’s knee is a positive McMurray test. This test is used to detect meniscal tears, which are suggested by the patient’s history of twisting injury, medial knee pain, swelling, and the catching sensation. A positive McMurray test indicates a meniscal tear when pain or a click is felt during the maneuver.
Incorrect Answer Explanations:
- A. Positive Lachman test: A positive Lachman test suggests an anterior cruciate ligament (ACL) tear. While the patient’s history of twisting injury could be consistent with an ACL injury, the catching sensation and localized medial pain are more indicative of a meniscal tear.
- C. Positive patellar apprehension test: A positive patellar apprehension test indicates patellar instability or dislocation, which is less likely given the history and symptoms described.
- D. Positive anterior drawer test: Similar to the Lachman test, a positive anterior drawer test suggests an ACL tear. The symptoms described are more indicative of a meniscal injury.
- E. Positive varus stress test: A positive varus stress test indicates injury to the lateral collateral ligament (LCL). The patient’s symptoms and medial knee pain are more suggestive of a meniscal tear.
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Covered under ⇒ PANCE Blueprint Musculoskeletal ⇒ ⇒
