Meniscal Tears Essay
The new Thessaly test for early detection of meniscal tears provides high level of accuracy in both specificity and sensitivity. The previous evidence based approach for detection of meniscal tears following subjective history was done by carrying out a combination of the McMurray’s test and joint line tenderness. The combination of the two was needed to rule in meniscal tear as McMurray’s test was high in specificity and low in sensitivity (Malanga, 2003 ). Specificity of the test was determined by a dull sound elicited on the medial joint line (Evans, 1993). While joint line tenderness was high in sensitivity and low in specificity (Malanga, 2003 ). Also, joint line tenderness had high specificity and high sensitivity when it was an isolated
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In Ellis’ study the combination of McMurray’s test and joint line tenderness was given a likelihood ratio of 2. Hence, if a test is positive the odds of the tear are doubled. However a score in between 0.5 to 2.0 was neutral with values greater than 10 providing strong evidence of pathology (Ellis, 2004). Hence, Thessaly’s test findings support the evidence based research as the likelihood ratio for a positive test is 39. This makes it a valid and reproducible physical examination technique for predicting meniscal tears (Harrison, …show more content…
The test adding to the current clinically accepted special tests for diagnosis of meniscal tears. As the study shows no difference in interpreting the test among inexperienced examiners, so no training as such is required. Also, the high agreement between examiners suggests its use as a confirmatory test with colleagues to rule in or out meniscal tear diagnosis.
However, Thessaly’s test has a low specificity in patients with combined ACL and meniscal injuries and cannot be recommended as a diagnostic test in this setting (Mirzatolooei, 2010). This reduces the diagnostic accuracy of detecting meniscal tear in athletes with concurrent ACL injury. Similarly, lack of adequate testing on acute meniscal tear and its accurate detection by the test has not been published (Peixoto, 2012). So patients with an acute tear of the meniscal tear might have to be referred on to an MRI to confirm the
In Ellis’ study the combination of McMurray’s test and joint line tenderness was given a likelihood ratio of 2. Hence, if a test is positive the odds of the tear are doubled. However a score in between 0.5 to 2.0 was neutral with values greater than 10 providing strong evidence of pathology (Ellis, 2004). Hence, Thessaly’s test findings support the evidence based research as the likelihood ratio for a positive test is 39. This makes it a valid and reproducible physical examination technique for predicting meniscal tears (Harrison, …show more content…
The test adding to the current clinically accepted special tests for diagnosis of meniscal tears. As the study shows no difference in interpreting the test among inexperienced examiners, so no training as such is required. Also, the high agreement between examiners suggests its use as a confirmatory test with colleagues to rule in or out meniscal tear diagnosis.
However, Thessaly’s test has a low specificity in patients with combined ACL and meniscal injuries and cannot be recommended as a diagnostic test in this setting (Mirzatolooei, 2010). This reduces the diagnostic accuracy of detecting meniscal tear in athletes with concurrent ACL injury. Similarly, lack of adequate testing on acute meniscal tear and its accurate detection by the test has not been published (Peixoto, 2012). So patients with an acute tear of the meniscal tear might have to be referred on to an MRI to confirm the