When examining a knee for a meniscal injury the commonly described tests are the McMurray Test and Apley Test. However, these tests have sensitivities of 48-68% and 41% respectfully, and specificities of 86-94% and 86-93% respectfully. Depending on whether you are looking at the medical or lateral meniscus.
The Tessaly Test that was first described in 2005 can be performed with knee in either 5 or 20 degrees of flexion and has a senstivity of 89-92% and specificity of 96-97% when performed in 20 degrees flexion. The test also tends to be easier to perform.
To perform the test:
Stand on affected leg only with the other leg held up in the air. The examiner holds hands for balance.
Flex knee to be test to 20 degrees, while the other leg is held in the air
Internally and Externally Rotate Knee
Positive test is pain at medial or lateral joint line with possible locking/catching sensation
Essentially you and your patient will look like you are doing the twist as they rotate their knee with you holding their hands.
References
The Journal of Bone and Joint Surgery (American). 2005;87:955-962.
