Benjamin E Smith1, Damian Thacker2, Ali Crewesmith1, Michelle Hall3. 1. Department of Physiotherapy Outpatients, London Road Community Hospital, Derby Hospitals NHS Foundation Trust, Derby, UK. 2. Department of Physiotherapy Outpatients, Ashfield Health Village, Kirkby-In-Ashfield, Nottingham, UK. 3. School of Health Sciences, Clinical Sciences Building, University of Nottingham, Nottingham, UK.
Abstract
BACKGROUND: Musculoskeletal knee pain is a large and costly problem, and meniscal tears make up a large proportion of diagnoses. ‘Special tests’ to diagnose torn menisci are often used in the physical examination of the knee joint. A large number of publications within the literature have investigated the diagnostic accuracy of these tests, yet despite the wealth of research their diagnostic accuracy remains unclear.Aim To synthesise the most current literature on the diagnostic accuracy of special tests for meniscal tears of the knee in adults. METHOD: An electronic search of MEDLINE, Cumulative Index to Nursing and Allies Health Literature (CINAHL), The Allied and Complementary Medicine Database (AMED) and SPORT Discus databases was carried out from inception to December 2014. Two authors independently selected studies and independently extracted data. Methodological quality was evaluated using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS) 2 tool. RESULTS: Nine studies were included (n=1234) and three special tests were included in the meta-analysis. The methodological quality of the included studies was generally poor. McMurray’s had a sensitivity of 61% (95% CI 45% to 74%) and a specificity of 84% (95% CI 69%to 92%). Joint line tenderness had a sensitivity of 83%(95% CI 73% to 90%) and a specificity of 83% (95% CI 61% to 94%). Thessaly 20° had a sensitivity of 75%(95% CI 53% to 89%) and a specificity of 87% (95% CI 65% to 96%). CONCLUSIONS: The accuracy of the special tests to diagnose meniscal tears remains poor. However, these results should be used with caution, due to the poor quality and low numbers of included studies and high levels of heterogeneity.
BACKGROUND:Musculoskeletal knee pain is a large and costly problem, and meniscal tears make up a large proportion of diagnoses. ‘Special tests’ to diagnose torn menisci are often used in the physical examination of the knee joint. A large number of publications within the literature have investigated the diagnostic accuracy of these tests, yet despite the wealth of research their diagnostic accuracy remains unclear.Aim To synthesise the most current literature on the diagnostic accuracy of special tests for meniscal tears of the knee in adults. METHOD: An electronic search of MEDLINE, Cumulative Index to Nursing and Allies Health Literature (CINAHL), The Allied and Complementary Medicine Database (AMED) and SPORT Discus databases was carried out from inception to December 2014. Two authors independently selected studies and independently extracted data. Methodological quality was evaluated using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS) 2 tool. RESULTS: Nine studies were included (n=1234) and three special tests were included in the meta-analysis. The methodological quality of the included studies was generally poor. McMurray’s had a sensitivity of 61% (95% CI 45% to 74%) and a specificity of 84% (95% CI 69%to 92%). Joint line tenderness had a sensitivity of 83%(95% CI 73% to 90%) and a specificity of 83% (95% CI 61% to 94%). Thessaly 20° had a sensitivity of 75%(95% CI 53% to 89%) and a specificity of 87% (95% CI 65% to 96%). CONCLUSIONS: The accuracy of the special tests to diagnose meniscal tears remains poor. However, these results should be used with caution, due to the poor quality and low numbers of included studies and high levels of heterogeneity.
Authors: Benjamin E Smith; Paul Hendrick; Toby O Smith; Marcus Bateman; Fiona Moffatt; Michael S Rathleff; James Selfe; Pip Logan Journal: Br J Sports Med Date: 2017-06-08 Impact factor: 13.800
Authors: Leonardo Côrtes Antunes; José Marcio Gonçalves de Souza; Nelson Baisi Cerqueira; Cleiton Dahmer; Breno Almeida de Pinho Tavares; Ângelo José Nacif de Faria Journal: Rev Bras Ortop Date: 2017-08-30
Authors: Sultan Abdulwadoud Alshoabi; Mohammed G Atassi; Mohammed A Alhamadi; A A Tashkandi; Kamal M Alatowi; Fawwaz S Alnehmi; Abdul-Rub A Binmodied; Moawia B Gameraddin; Tareef S Daqqaq Journal: J Family Med Prim Care Date: 2020-02-28