The role of clinical diagnosis in meniscal lesions of the knee.

The aim of the present paper is to evaluate the importance of clinical examination in the process of diagnosing meniscal lesions, as well as to establish the accuracy of clinical examination in comparison to the arthroscopic diagnosis. In the last 5 years, in the Orthopedic Surgery Clinic in Skopje, the authors have diagnosed and treated 205 patients suffering from meniscal lesions. The method of anamnestic testing, and of clinical examination and the statistical method have been applied. All the patients were subjected to the following tests: well taken anamnesis of the knee injury mechanism, standard orthopedic examination (Stainman I and II, McMurray and Appley test), standard radiographic images of the knee, additional examination with MRI for some of the patients and arthroscopic examination. The results obtained with clinically established diagnosis were compared to the results obtained with arthroscopic diagnosis. Comparing the results of the clinical and arthroscopic diagnoses, an insufficiency of the clinical diagnosis of almost 20% was established. The results are close to those given in the professional literature which refers to the standardized approach in taking the anamnestic data and the realization of the physical signs and tests examination technique. It means that the physical signs and tests, as well as the well-taken anamnesis, are the foundation for establishing a diagnosis of meniscal lesions. Arthroscopy is truly the only golden standard for the diagnosis of all entities of the knee joint, including meniscal lesions.