Symptoms and Signs
The patient's chief complaints are usually knee pain and swelling. These are worse when the knee bears more weight (for example, when running). Another typical complaint is joint locking, when the patient is unable to straighten the leg fully. This can be accompanied by a clicking feeling. Sometimes, a meniscal tear also causes a sensation that the knee gives way.
The patient can sometimes remember a specific activity during which the injury was sustained. A tear of the meniscus commonly follows a trauma which involves rotation of the knee while it was slightly bent. These maneuvers also excite the pain after the injury; for example, getting out of a car is often reported as painful.
After noting symptoms, a physician can perform clinical tests to determine if the pain is caused by compression and impingement of a torn meniscus. The knee is examined for swelling. In meniscal tears, pressing on the joint line on the affected side typically produces tenderness. The McMurray test involves pressing on the joint line while stressing the meniscus (using flexion–extension movements and varus or valgus stress). Similar tests are the Steinmann test (with the patient sitting) and the Apley grind test (a grinding maneuver while the patient lies prone and the knee is bent 90°). Bending the knee (into hyperflexion if tolerable), and especially squatting, is typically a painful maneuver if the meniscus is torn. The range of motion of the joint is often restricted.
The Cooper's sign is present in over 92% of tears. It is a subjective symptom of pain in the affected knee when turning over in bed at night. Osteoarthritic pain is present with weightbearing, but the meniscal tear causes pain with a twisting motion of the knee as the meniscal fragment gets pinched, and the capsular attachment gets stretched causing the complaint of pain.
Also see: bounce home test, Thessally's test, Wilson test (internal/external rotation), and Bohler's test.
Read more about this topic: Tear Of Meniscus
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