A Prospective Observational Study Comparing Weight Bearing versus Non-Weight Bearing Clinical tests for diagnosing Meniscal tear in Comparison with MRI study

Abstract

Background: Meniscal tears typically result from acute sports injuries or direct trauma to the knee. Delayed diagnosis and conservative treatment may exacerbate complications. Objectives: To compare the sensitivity, specificity, positive and negative predictive value of various weight bearing (Thessaly test, Ege’s test, Duck walk test) and non-weight bearing clinical tests (Joint line tenderness, McMurray’s test, Apley’s test) for meniscal tear in comparison with MRI. Methods: This was a hospital based, prospective, observational, cross-sectional study conducted at the outpatient department (Knee Clinic) and/or inpatient wards of the Department of Orthopedics, Aarupadai Veedu Medical College, for a duration of 24 months, among patients more than 18 years of age, of both gender, suspected of meniscal tear, identified as needing arthroscopy and those willing to provide informed written consent. Results: Employing a combination of the Thessaly test, Ege's test, and the Duck walk test significantly enhances the diagnostic accuracy for detecting meniscal tears. Notably, even if only one of these weight-bearing tests yields a positive result, it demonstrates high specificity and positive predictive value, indicating that a positive finding in any of these tests strongly suggests the presence of a meniscal tear. However, the sensitivity remains low, implying that relying solely on one weight-bearing test may lead to missed diagnoses. Conclusion: In summary, this study offers valuable insights into the diagnostic accuracy of both weight-bearing and non-weight-bearing clinical tests for identifying meniscal tears, as compared to magnetic resonance imaging (MRI), within a cohort of patients with knee symptoms. Through a comprehensive evaluation of various clinical tests, we have highlighted their individual and combined contributions to the accurate diagnosis of meniscal tears.