Meniscus test

introduction

The knee joint is one of the largest human joints and exposed to great stress. Parts of the knee joint that are used for cushioning and better mobility are the menisci. Everyone has an inner meniscus and an outer meniscus. Especially with athletes or people who put a lot of stress on their knees due to work (e.g. tilers), this can Menisci take damage.

This then plays a role in diagnostics Meniscus test plays a major role, as this can quickly corroborate the suspicion of meniscus damage without using diagnostic equipment. A Meniscus test becomes manually by the attending physician performed by provokes pain through certain movements become.

Known meniscus tests are Steinmann or McMurray such as Payr, Apley or the Meniscus test according to Böhler.

causes

Causes of Meniscus Damage, the one Meniscus test require are mainly through high sports loads conditionally. These include violent forces from outside or chronic stresses that go beyond a healthy level. Football players, skiers, but also runners have an increased risk of being harmed here. In addition, people who work a lot while standing or kneeling are also more likely to be affected. Another Age is a risk factor, so that basically anyone can suffer meniscus damage. It becomes general one acute meniscus tear with immediate symptoms of chronic degenerative damage with gradual development distinguished.

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Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
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The knee joint is one of the joints with the greatest stress.

Therefore, the treatment of the knee joint (e.g. meniscus tear, cartilage damage, cruciate ligament damage, runner's knee, etc.) requires a lot of experience.
I treat a wide variety of knee diseases in a conservative way.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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Symptoms

The Main symptom one damaged meniscus are Pain. These often appear in a characteristic way and thus form the background to the Meniscus test. Depending on the affected meniscus, the pain mainly affects the Inside or outside of the knee and is movement-dependent, i.e. the pain worsens with Turning or bending movements in the knee. Sometimes they also radiate in from the knee Thigh or lower leg out. In addition, there is usually a restriction of movement caused by the pain.

Diagnosis with meniscus test

The Diagnosis of a meniscus lesion consists of several parts.
In addition to the apparatus and imaging methods, a Meniscus test at the beginning of every investigation. A Meniscus test like the test according to Steinmann, Payr, McMurray, Apley or Böhler is carried out quickly, gives important information on extent and localization and can be used by many examiners. As a background for Meniscus test one moves the knee joint in a certain wayto stretch or irritate the menisci and cause pain in the event of damage.
Is a Meniscus test A positive MRI of the knee joint usually follows to confirm the suspected diagnosis.
Read more on this topic at: MRI knee joint

It exists various testswhich are named after the person who first described them and are easy to learn.

1. Steinmann: Of the Meniscus test according to Steinmann is further subdivided into Steinmann I., a very telling one Meniscus test, and Steinmann IIwhich is rather secondary. Steinmann I: At the Meniscus test Steinmann I, the patient lies flat on his back and sets up the affected leg so that the Knee joint bent 90 ° is. The examiner summarizes with one hand on the back of the knee and palpates the joint spacewhile the other grabs around the ankle. Then this is where the Lower leg forced inwards or rotated outwards. Pain in the knee with internal rotation suggests damage to the external meniscus; external rotation affects the internal meniscus. Steinmann II: With Steinmann II you feel with the knee extended on the side of the joint for pain points. Once these have been found, the patient is allowed to bend the knee while continuing to search for points with painful pressure. If the pain point moves further back, this indicates an injury to the meniscus on the same side.
2. Payr: Another one that is quick to do and more informative Meniscus test is the Payr test. Of the Affected person sits cross-legged, while the examiner presses the externally rotated knee joints down in a resilient manner. Of the Meniscus test according to Payr is positive if pain on the inside of the knee joint when pressed occur. Then there is one Damage to the medial meniscus close. The Payr test can also laying performed by placing the outside ankle of the affected leg behind the knee of the other leg.
3. McMurray: Of the Meniscus test according to McMurray is a sensitive test for meniscus damage. The implementation at McMurray is similar to that of the Steinmann test. The patient lies on his back. According to McMurray, the examiner lifts the affected leg and bends it in the knee joint, while the joint space of the knee is felt with the thumb and index finger of one hand. In this meniscus test, the knee is rotated outward to test the inner meniscus, and vice versa. Then the leg is slowly stretched while constantly feeling in the joint space. If pain occurs here, McMurray is positive and a meniscus lesion on the painful side is likely. In addition, McMurray also has a Pay attention to a noticeable click in the gapwhich is also an indication of damage.
4. Apley: The Apley test is a Meniscus test, of the in the prone position is carried out. With Apley, the patient lying on his stomach also bends his knee at 90 ° so that the foot points upwards. Then, according to Apley, the examiner exerts pressure on the sole of the foot vertically from above in order to load the knee. At the same time, the knee joint rotates inwards or outwards again. If there is a corresponding damage, Painful with internal rotation of the external meniscus and with external rotation the internal meniscus, Apley is positive.
5. Boehler: The Böhler test is also used in practice to detect meniscus damage. This Meniscus test does not work with rotation, but according to Böhler the lower leg is moved laterally against the knee. You lie on your back with your leg straight. Of the Examiner fixes the knee and thighin order to then move the lower leg vertically around an imaginary axis through the kneecap. It abducts (tilts outwards) and adducts (tilts inwards) the lower leg. The movement is minimal, rather pressure is exerted on the menisci. In the Böhler test, in Adduction position of the inner meniscus, with abduction the outer meniscus tested. The Böhler meniscus test provides indications of damage.

A Meniscus test, whether Steinmann, Payr, McMurray, Apley or Böhler, gives indications in many cases whether a meniscus is damaged or not. Most of the time, the tests are positive for a lesionwhich, however, does not have to be evidence of meniscus damage. So will be at the same time Ribbons and other structures tested, which can also be painful. At the same time, a negative meniscus test does not rule out any damage, so that the result is Meniscus test always has to be seen in the overall context. Nevertheless, positive results offer enough reason to research further in this direction, e.g. in the form of an MRI scan or an arthroscopy.

therapy

A Meniscus damage should always be treated appropriately. The type of treatment depends on the Size of the damage and according to the localization, i.e. whether only outer areas are affected or also central areas.

The conservative therapy consists mainly of Protection of the joint, Pain therapy and patience. Medicines such as cortisone can also be given to the joint. Surgery is often necessary, especially in the case of major damage, the existing meniscus sewn on or replaced can be. Sometimes some tissue has to be removed.

forecast

A Meniscus test can play a role in the prognosis, since the Damage discovered early can be. In addition, above all that The extent of the injury is decisive for healing. Small damage heals after a few weeks, if surgery is necessary, healing takes longer. In unfavorable cases, sports such as football or skiing must be avoided.

prophylaxis

As many Meniscus damage results from accidents, prophylaxis is difficult. There are Knee wraps and supportsthat stabilize the knee. A well trained knee muscles also reduces the risk. Occupationally stressed people must and be able to take sufficient breaks Knee protectors or padsthat allow long kneeling on the floor.