The predictive value of five clinical signs in the evaluation of meniscal pathology.

One hundred sixty-one consecutive patients with knee pain of at least 1 year's duration were studied on a prospective basis to determine the predictive value of five common clinical tests for the diagnosis of meniscal tears. Each patient had a preoperative examination that evaluated the presence or absence of joint line tenderness, pain on forced flexion, the presence of a positive McMurray test, positive Apley grind and distraction tests, and the presence of a block to extension. The results of these tests were then compared to arthroscopic findings. This study indicates that no one test is predictive for the diagnosis of a meniscal tear; a combination of tests should be used. The presence of anterior cruciate ligament pathology will render these tests less effective for diagnosis of meniscal pathology. Chondromalacia patella is negatively correlated with the presence of joint line tenderness and pain on forced flexion.