Which test is performed with single-leg weight-bearing and internal rotation to assess meniscal pathology?

Which test is performed with single-leg weight-bearing and internal rotation to assess meniscal pathology?

• A. Joint Line Tenderness
• B. Thessaly
• C. Patellar Tilt Test
• D. McMurray

Answer: (B)

This test relies on provocative loading of the knee to reveal a meniscal tear. By standing on one leg (single-leg weight-bearing) and rotating the tibia inward, the femoral condyles compress and shear the menisci against each other. This creates symptoms if a meniscal tear is present, because the torn edge or disrupted meniscal tissue catches or blocks during rotation and weight-bearing. Performing the test at two knee angles—about 5 degrees of flexion and then about 20 degrees—enhances sensitivity, since different tear patterns may be more evident at different degrees of flexion. A positive sign is the patient’s report of joint-line pain, or a catching/locking sensation, reproduced with the internal rotation. Internal rotation specifically stresses the medial meniscus, so a medial meniscal pathology is more likely if symptoms arise with this maneuver. Other tests described are less about reproducing dynamic tibial rotation under load. Joint line tenderness is a palpation finding rather than a provocative motion. The Patellar Tilt Test assesses patellofemoral alignment rather than meniscal integrity. The McMurray test uses flexion–extension with combined rotation and can produce a click, but it involves multiple steps and different knee positions, not the single-leg, weight-bearing, internal-rotation approach used here.

This test relies on provocative loading of the knee to reveal a meniscal tear. By standing on one leg (single-leg weight-bearing) and rotating the tibia inward, the femoral condyles compress and shear the menisci against each other. This creates symptoms if a meniscal tear is present, because the torn edge or disrupted meniscal tissue catches or blocks during rotation and weight-bearing.

Performing the test at two knee angles—about 5 degrees of flexion and then about 20 degrees—enhances sensitivity, since different tear patterns may be more evident at different degrees of flexion. A positive sign is the patient’s report of joint-line pain, or a catching/locking sensation, reproduced with the internal rotation. Internal rotation specifically stresses the medial meniscus, so a medial meniscal pathology is more likely if symptoms arise with this maneuver.

Other tests described are less about reproducing dynamic tibial rotation under load. Joint line tenderness is a palpation finding rather than a provocative motion. The Patellar Tilt Test assesses patellofemoral alignment rather than meniscal integrity. The McMurray test uses flexion–extension with combined rotation and can produce a click, but it involves multiple steps and different knee positions, not the single-leg, weight-bearing, internal-rotation approach used here.