Diagnosing meniscal tears in the emergency department
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Diagnosing meniscal tears in the emergency department

Megan Doherty Senior diagnostic radiographer and emergency care practitioner, Gloucestershire Royal Hospital
Rebecca Hoskins Consultant nurse and senior lecturer in emergency care, University of the West of England

Megan Doherty and Rebecca Hoskins examine the method and accuracy of three tests for a common soft tissue injury of the knee

Acute meniscal knee injuries can lead to instability of the joint if they are left untreated, but clinical examinations of patients’ acutely injured knees can be challenging because of the pain and swelling involved. Although magnetic resonance imaging and arthroscopy are the gold standard investigations for the diagnosis of meniscal tears they cannot always be carried out in acute or emergency department settings. It is therefore essential that emergency care practitioners have good clinical examination skills to ensure safe and effective patient management, diagnosis, and outcomes, as well as the skills and knowledge required to carry out meniscal tear tests. This article reviews the literature on the most common examination techniques associated with acute injuries, especially meniscal injuries, to knees: joint line tenderness assessment, McMurray’s test and the Apley’s grind test. It analyses the sensitivity and specificity for each test to help practitioners understand the clinical significance of positive and negative findings.

Emergency Nurse. 23, 3,31-36. doi: 10.7748/en.23.3.31.e1428

Correspondence

megan_doherty42@hotmail.co.uk

Peer review

This article has been subject to double-blind review and has been checked using antiplagiarism softwar

Conflict of interest

None declared

Received: 23 February 2015

Accepted: 15 April 2015