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Baker PE, Peckham AC, Pupparo F, Sanborn JC. 2017 Mar;101(Suppl 1):23-35. doi: 10.1007/s12306-017-0460-5. Anterior cruciate ligament reconstruction: MR imaging findings. During the maneuver, the joint line is palpated both medially and laterally. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you. and transmitted securely. Of the 11 studies identified in this review, nine used arthroscopy as the reference standard, one used MRI, and the remaining study used both MRI and arthroscopy (Table (Table44). ZDZkZjczMGZkNzQ1OWMxZTQyNDY2ZTAzYTM5OTk2ZmQ1YjkzNDFjMDhmNzMy A wide variety of clinical tests are used to diagnose meniscal pathology within the knee joint. Clinically, we do not know whether a patient has the condition before the diagnostic test (arthroscopy or MRI) is performed. Varus Stress Test [1] Magee DJ. The accuracy of joint line tenderness by physical examination in the For the varus stress test, the patient is in supine position and asked to relax. Clinical Rehabilitation, 22(2), 143-61. Reid MC, Lachs MS, Feinstein AR. Sensitivity: 25%. St. Louis, MO: Saunders Elsevier;2008. YzA0Nzk1ZjQxYjY5Mzg4MWUwNDRlODM0NDRiNzZiM2I4OWVhNTQ1YmVlMDNj It is primary restraint to varus rotation from 0-30 of knee flexion. McMurray test | Radiology Reference Article | Radiopaedia.org Manoeuvres assessing the posterolateral structures include the varus stress test, dial test, the posterolateral drawer, the external rotation recurvatum test, heel height test and the reverse pivot shift. Notes Maximum dorsiflexion locks the subtalar joint and improves the sensitivity of this test. OThmMmM0YTcwMmQwODZhZWFkYzNjNzRlOTkzZiIsInNpZ25hdHVyZSI6IjVh The wide range of positive likelihood ratios (0.828.86) make it difficult to draw any conclusions about the actual magnitude of this ratio. Muellner T, Weinstabl R, Schabus R, Vecsei V, Kainberger F. The diagnosis of meniscal tears in athletes: A comparison of clinical and magnetic resonance imaging investigations. Evaluation of knee instability in acute ligamentous injuries. One problem with these modified tests is that they appear to have all been evaluated by the creators of the tests, which to some degree challenges the validity of the research. The STARD checklist contains 25 items that help to make a judgment about potential bias in the study and appraisal of the applicability of the findings. 13th ed. [4] The popliteus tendon is deep to the LCL, seperating it from the lateral meniscus. Hoppenfeld S, Hutton R, Hugh T. Physical examination of the spine and extremities. If a study evaluates a test in a very specific group of patients, its findings can only be applied to that same type of cohort. These authors demonstrated significantly larger (better) positive likelihood ratios and significantly smaller (better) negative likelihood ratios than the McMurray's. YWU3NTg0YTg5NzcxMzE4M2I5NjZiYzgxNzlkYjQyNmRjYjE1OWNjZjJmNzVh The accuracy of the clinical knee examination documented by arthroscopy: A prospective study. Epub 2018 Jul 27. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). Conclusions: The final study by Sae-Jung et al24 compared a modified version to McMurray's added axial compression, similar to that applied by Kurosaka et al6 but without added valgus or varus stress. Patients identified as needing arthroscopy excluding those with intra-articular fracture, neurological or degenerative disorders. 1. Likelihood Ratio +/-. The test is fairly solid. Assessment of the menisci and cruciate ligaments: An audit of clinical practice. The LCL acts as a secondary stabilizer to anterior and posterior tibial translation when the cruciate ligaments are torn. The test is fairly solid. M2EwZWY0Zjg3ZDdlZTMzNDhjY2EwMzdkMmRjZmQ1M2M1OTI3ZDRiZDk0NzYx National Center for Biotechnology Information https://www.physio-pedia.com/index.php?title=Lateral_Collateral_Ligament_of_the_Knee&oldid=221054, A direct blow to the anteromedial knee and posterolateral corner, 0: Posteriolateral capsule, arcuate-popliteus complex, anterior and posterior cruciate ligaments, lateral gastrocnemius, 20-30: Posteriolateral capsule, arcuate-popliteus complex, iliotibial band, biceps femoris tendon. Sensitivity and specificity of this test are only 38% and 41%, respectively. Moore KL, Dalley AF, Agur AMR. The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user. Similarly, Corea et al4 included consecutive patients who were clinically diagnosed as having torn menisci based on a number of signs and symptoms including locking, a positive McMurray's test, painful clicks, and giving way. Akseki D, Ozcan O, Boya H, Pinar H. A new weight-bearing meniscal test and a comparison with McMurray's test and joint line tenderness. Epub 2018 Jul 17. In one of these studies, the CIs are extremely wide5. Similarly, sensitivity figures ranged from 27% to 70% across the reviewed papers, generally indicating that a torn meniscus is likely to be missed in many patients; however, specificity figures (2996%) indicating that false positive tests are relatively low and that a positive test makes it likely that the patient actually does have a torn meniscus. Accuracy is the percentage of subjects who are correctly identified as either having or not having a meniscal tear. Likelihood ratios overcome some of the problems involved with sensitivity and specificity values by summarizing the information contained in these values in a manner that can be used to quantify shifts in probability once the meniscal test results are known28. The possibility of there being associated intra-articular pathology (such as anterior cruciate ligament rupture) confounds results, and the unknown validity, sensitivity, and specificity of the tests make it difficult for the clinician to be confident in making a definitive diagnosis3. If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. The goal of the study was to evaluate 3 common manual tests (Buell, Dananberg, and Jack tests) for assessing first metatarsophalangeal joint (MPJ) mobility and determining the normal values needed to detect FHL . Evans et al23 used consecutive patients on a waiting list for arthroscopy for a variety of conditions including, but not limited to, suspected meniscal tears. . Yedlinsky, N.T. -----BEGIN REPORT----- This trade-off between sensitivity and specificity makes it important that they be considered jointly27. Human Kinetics, 2008. When confidence intervals are not present, the CIs were incalculable due to absence of raw data. Comparable sensitivity and specificity were shown in regards to the Thessaly test, 85.4% and 54%, respectively.