Tests

The patient lies on his stomach and has one knee bent at 90°. The examiner now fixes the patient’s thigh with one hand or leg. At the same time, he rotates the patient’s leg with the other hand, once under pressure and once under tension.

If pain occurs during the external rotation, there is damage to the inner meniscus. This test is also called abduction and adduction stress test. The examiner uses one hand to stabilize the patient’s thigh while lying on his back, and the other hand to cover the ankle region.

To test the inner meniscus, the upper hand grasps the inside of the thigh or knee and the lower hand grasps the outer ankle. Now the examiner bends and stretches the leg while simultaneously adducting it, i.e. placing it under varus stress. The compression pressure during the examination can cause pain in the corresponding meniscus, in this case the inner meniscus, and indicates its lesion.

For this test, the patient must assume a tailor-made sitting position on the examination couch.The examiner now presses the knees, which are currently in an outwardly rotated and flexed position, moderately strongly towards the support. If the pressure exerted in the medial joint space is perceived as painful, the patient probably has an inner discus lesion in the posterior region. The Steinmann I test aims to trigger pain in rotation.

The patient lies on his back and bends the knee about 30°. The examiner grasps the lower leg with one hand and the heel with the other, from where he performs one internal rotation and then an external rotation. Pain during external rotation for damage to the inner meniscus.

In the second Steinmann test, the patient also lies on his back. By palpating the medial and lateral joint space, the examiner tries to trigger pain in the respective meniscus (medial pain = inner meniscus lesion). It is important that the pain point can move: During flexion, the pain in the affected joint space moves backwards and during extension it moves forwards.

In addition, the examiner rotates the patient’s leg inwards and outwards while simultaneously exerting axial compression (i.e. pressure from below against the knee joint). Pain from external rotation is indicative of internal meniscus lesions. Other functional tests that are not explained in detail are the Bragard test, the Cabot test, the Childress sign, the McMurray test (Fouche sign), the Anderson compression test, the Merke test, the “Thessaly test”, the Turner sign, the Pässler rotational compression test and the Tschaklin sign. In the case of chronic meniscus lesions, arthroscopy may also be indicated.