Symptoms
Typical symptoms of meniscus damage are stabbing pains in the knee, which can occur with even the slightest movement and in severe cases even at rest. In acute injuries, the pain occurs suddenly and shooting. In contrast, age-related meniscus damage causes a gradual increase in pain over a longer period of time.
In addition, it can lead to a restriction of movement in the knee joint. Depending on the location of the meniscus damage, an effusion in the knee joint is also possible. Especially the middle area of the meniscus is well supplied with blood and can lead to an effusion in case of a tear.
The knee is then usually swollen and warm. However, not every torn meniscus necessarily causes symptoms and may not even be noticed, so that it grows back on its own.A precise diagnosis is important to find out the severity as well as the localization of the meniscus damage and is usually made by a general practitioner or orthopedist, a specialist for diseases of the musculoskeletal system. The physician will first conduct a thorough interview regarding the type, frequency and circumstances under which the knee joint pain occurs.
He will also be interested in your lifestyle, such as your job and sports activities, as well as knee operations that have already been performed. Subsequently, during the physical examination, special tests, known as Steinmann or Payrtest, will be performed on your knee joint. The physician uses a specific procedure to move the thigh in relation to the lower leg, thereby placing stress on the inner and outer meniscus.
Depending on which movement causes pain, the physician can narrow down his suspicion of meniscal damage to the extent that it is an injury in the area of the inner or outer meniscus. In addition, the examiner will examine for pain when touched as well as stretching problems in the knee joint. The physician diagnoses a knee joint effusion using the so-called “dancing kneecap” method.
In this method, the kneecap is enclosed by the thumb and middle finger in a C-shape and pressed in with the index finger. In case of an effusion, the examiner feels the floating patella in the liquid. If an accident was the cause of the meniscus damage, the physician takes an X-ray of the knee joint to rule out injuries to the surrounding bony structures.
Age-related changes in the knee joint, such as joint wear and tear, can also be made visible in the X-ray image. A meniscus damage in itself cannot be shown in the X-ray image. For this reason, the most important imaging instrument in suspected meniscus damage is the so-called X-ray-free magnetic resonance imaging, also known as nuclear spin.
In this procedure, organs and soft tissues, such as the menisci, are shown in sectional images with high resolution. A healthy meniscus is shown as a continuous black stripe, wear and tear due to bright spots and meniscal damage as a bright tear in the image. With this diagnostic tool, the extent and location of the meniscus damage can be optimally determined.
An equally reliable method, but one that requires minimal surgery, is arthroscopy, i.e. joint endoscopy. Two small incisions are made in the knee joint under local anesthesia. A camera and light are introduced through one of the incisions and examination instruments through the other.
The advantage of arthroscopy is that the meniscus damage can be treated directly if the findings are positive. A non-standard examination of the meniscus damage is the ultrasound of the knee joint, which is only used if further damaged structures around the meniscus are suspected. It can be used to diagnose injuries to the ligamentous apparatus or effusions of the knee joint.