Which test is performed with the patient supine, one hand at the knee and the other on the distal tibia, where from maximal knee flexion the knee is extended with internal rotation and then returned to flexion, repeated with external rotation, to assess meniscal pathology?

• A. Apley compression test
• B. McMurray's test
• C. Bounce home test
• D. Thessaly test

Answer: (B)

The test targets diagnosing a meniscal tear by provoking the knee through a combined movement that traps a torn meniscal edge between the femur and tibia. In this maneuver, the patient lies on their back while one hand stabilizes the knee and the other grasps the distal tibia. Starting from maximum knee flexion, the clinician extends the knee while rotating the tibia internally, then returns to flexion; this is repeated with external tibial rotation. A positive sign is a painful click or a discernible click with extension, indicating a torn meniscus.

The rotation direction matters because external rotation stresses the medial meniscus, while internal rotation stresses the lateral meniscus. By performing the test with both rotations, you can detect tears in either meniscus based on where the symptomatic click or pain occurs.

This approach is particularly specific for meniscal pathology because it directly uses knee motion to engage the torn tissue, unlike tests that rely on general pain or pain with compression alone. Other tests in this area use different positions or maneuvers (for example, compression with rotation in a prone position, or a weight-bearing twist test), which makes them less targeted for eliciting the classic meniscal tear sign in a standard exam scenario.