Which condition does Wilson's Test specifically help diagnose?

• A. Patellofemoral pathology
• B. Osteochondritis Dissecans
• C. Plica
• D. Meniscal tear

Answer: (B)

Wilson's test targets an osteochondral lesion of the medial femoral condyle, a form of osteochondritis dissecans in the knee. The maneuver places the knee in a flexed position and then extends it while the tibia is internally rotated; this motion compresses the medial femoral condyle against the tibial plateau. If a lesion is present, this repetitive impingement during the terminal range of extension provokes pain that is elicited with internal rotation and relieved when the tibia is externally rotated. This pattern—pain reproduced with internal rotation during extension and alleviated with external rotation—best distinguishes OCD of the medial femoral condyle from other knee issues.

Other conditions involve different structures and test patterns. Patellofemoral pathology usually presents with pain around the patella during quad loading or knee bending and has its own specific tests. Plica syndrome involves crepitus or snapping with folds of synovial tissue, detected by tests targeting the plica. Meniscal tears are more often indicated by tests like the McMurray or Thessaly that reproduce pain with joint rotation and compression rather than the rotational-extension impingement described in Wilson's test.