Learning outcome
- Meniscus injury
- Ligament injury
- Patellofemoral pain syndrome
- Suspected patella and fibula fracture
Special tests
- McMurray's test
- Apley's test
- Drawer test
- Lachman's test
- Grinding test
- Ottawa knee rule
Case 8
You are working as a fifth-year student at a general practitioner’s office. The next patient is a 24-year-old man, a student. He plays football in his spare time. He is presenting due to pain in his right knee joint after a twisting injury four weeks ago. He has tried some gentle activity over the past week. The pain worsens with activity and he feels that the knee joint gives way under load. He has also noticed a reduced ability to fully extend and something he experiences as possible transient locking.
- Explain how you would examine the patient looking for a meniscus injury
Knee examination
- Perform a standard knee examination (Module 2.4)
- Inspection
- Active movement
- Passive movement
- Isometric movement
- Palpation
- Rule out ligament injury
- Perform meniscus tests
Grinding test
Cruciate ligament test
Meniscus tests
Clinical findings
- During passive extension, you get the impression of an elastic end-feel that stops before full extension; the patient reports pain.
- There is slight hydrops in the knee joint.
- During meniscus tests, the patient reports pain in the knee joint, slightly uncertain localization, mostly medial.
- During passive valgus stress on the extended knee, the patient reports pain.
- You find tenderness on palpation medially on the tibia just below the joint space.
What is wrong with the patient?
The patient has an injury in the medial meniscus.