Analogous to the medial aspect of the knee, the lateral meniscus can be palpated at the upper edge of the lateral tibial plateau (Fig. 2.1b) and the LCL can be palpated as it extends from the lateral femoral epicondyle to the fibular head.
Where can the lateral meniscus be palpated?
( b) Palpation of lateral meniscus The lateral knee must also be evaluated carefully with palpation. Analogous to the medial aspect of the knee, the lateral meniscus can be palpated at the upper edge of the lateral tibial plateau (Fig. 2.1b) and the LCL can be palpated as it extends from the lateral femoral epicondyle to the fibular head.
Do you have a knee meniscus tear?
When dealing with knee pain, it can be unclear where the pain is stemming from. But by identifying if you may have a knee meniscus tear or not, you can begin the healing process more efficiently. Meniscus tears are among the most common knee injuries in individuals 50 and over. It often leads to pain and a limited range of motion, yikes!
What does it mean when you pop your meniscus?
This cartilage is your meniscus. Each of your knees has two meniscus wedges. Meniscus tears are common among athletes, especially those who play sports that require a lot of squatting, twisting, and changing positions. You will feel a pop when your meniscus is torn.
Can a meniscus be torn by putting full weight on it?
It can be torn if you suddenly twist your knee while bearing weight on it. A torn meniscus is one of the most common knee injuries. Any activity that causes you to forcefully twist or rotate your knee, especially when putting your full weight on it, can lead to a torn meniscus.
Can you feel your meniscus?
Individuals with a meniscus tear often complain of pain along the joint line. They often have pain or weakness with bending the knee and sometimes they have a catching or locking sensation. With an acute tear, individuals may notice a lot of swelling in the knee and often report that they heard or felt a pop.
Can you palpate medial meniscus?
Tenderness to palpation may be observed in patients with a medial meniscal tear. It is important to palpate the along the joint line to its most posterior aspect as many tears involve the posterior horn of the medial meniscus.
Where does the medial meniscus palpate?
0:202:11E39: Medial Meniscus Knee Palpation - YouTubeYouTubeStart of suggested clipEnd of suggested clipSo with medial meniscus injuries. If you're going to palpate it. I take the hands the the thumbMoreSo with medial meniscus injuries. If you're going to palpate it. I take the hands the the thumb right here and slide all the way down the quad you'll feel the quad drop off there get into something
How do I locate my meniscus?
The menisci sit between the tibia (lower leg bone) and the femur (thigh bone) and protect the lower part of the leg from the shock created by our body weight. The medial meniscus sits on the inside of the knee and the lateral meniscus sits on the outside of the knee.
How do you assess for a torn meniscus?
DiagnosisX-rays. Because a torn meniscus is made of cartilage, it won't show up on X-rays. But X-rays can help rule out other problems with the knee that cause similar symptoms.MRI . This uses a strong magnetic field to produce detailed images of both hard and soft tissues within your knee.
Does a torn meniscus hurt to touch?
When a meniscus tear occurs, you may hear a popping sound around your knee joint. Afterward, you may experience: pain, especially when the area is touched.
Can you palpate an MCL tear?
Palpation should be performed along the full length of the MCL. Tenderness specifically at one attachment site indicates the injury likely occurred there. Mid-substance tears can cause tenderness at the medial joint line, which can be confused with a medial meniscus injury.
How do you palpate a medial joint knee?
4:5413:00Knee Joint Palpation | Clinical Physio - YouTubeYouTubeStart of suggested clipEnd of suggested clipAlong the medial aspect of the joint line right round to the very medial. Side of the knee. And fromMoreAlong the medial aspect of the joint line right round to the very medial. Side of the knee. And from here we're palpating the anterior horn of the medial meniscus.
Is the MCL palpable?
The anterior aspect of the ligament can be palpated moving vertically, roughly midway along the medial joint line. Focal tenderness indicates an MCL injury.
What are 3 signs of a meniscus tear in the knee?
SymptomsA popping sensation.Swelling or stiffness.Pain, especially when twisting or rotating your knee.Difficulty straightening your knee fully.Feeling as though your knee is locked in place when you try to move it.Feeling of your knee giving way.
What does a meniscus feel like?
Pain in the knee. Swelling. A popping sensation during the injury. Difficulty bending and straightening the leg.
Can I tear my meniscus and not know it?
Meniscal tears do not always cause symptoms or problems. In some cases, there may be severe pain and a popping sensation when the injury occurs. Other times the swelling within the knee joint may take a few hours to develop.
How do you palpate a medial joint knee?
4:5413:00Knee Joint Palpation | Clinical Physio - YouTubeYouTubeStart of suggested clipEnd of suggested clipAlong the medial aspect of the joint line right round to the very medial. Side of the knee. And fromMoreAlong the medial aspect of the joint line right round to the very medial. Side of the knee. And from here we're palpating the anterior horn of the medial meniscus.
Can the MCL be palpated?
Palpation should be performed along the full length of the MCL. Tenderness specifically at one attachment site indicates the injury likely occurred there. Mid-substance tears can cause tenderness at the medial joint line, which can be confused with a medial meniscus injury.
How do you palpate the MCL of the knee?
0:001:35Knee Ligament Palpation - YouTubeYouTubeStart of suggested clipEnd of suggested clipYou can operate the joint space by flexing and extending your partner's knee and you feel the tibiaMoreYou can operate the joint space by flexing and extending your partner's knee and you feel the tibia distally. And the femur. Proximally. Feel the margin of the joint.
What does a medial meniscal tear feel like?
A popping sensation. Swelling or stiffness. Pain, especially when twisting or rotating your knee. Difficulty straightening your knee fully.
Which joint can be palpated?
The biceps femoris and iliotibial tract can also be palpated as they cross the knee joint to insert on the fibular head and lateral tibial tubercle, respectively. Palpation of the lateral joint line can be facilitated by placing the knee in a crossed position, or the “figure of four” position.
Where is the lateral knee palpated?
Analogous to the medial aspect of the knee, the lateral meniscus can be palpated at the upper edge of the lateral tibial plateau (Fig. 2.1b) and the LCL can be palpated as it extends from the lateral femoral epicondyle to the fibular head. Tenderness to palpation along the lateral joint line can indicate a lateral meniscus tear, LCL injury, or lateral compartment osteoarthritis. The biceps femoris and iliotibial tract can also be palpated as they cross the knee joint to insert on the fibular head and lateral tibial tubercle, respectively. Palpation of the lateral joint line can be facilitated by placing the knee in a crossed position, or the “figure of four” position. This places a varus moment on the knee, opening up the lateral compartment. The LCL can easily be palpated running from the lateral epicondyle to the fibular head, and posterior to this structure on the joint line is the lateral meniscus body and posterior horn segment. Care must be taken to differentiate joint-line tenderness from popliteus tendonitis (more proximal) or iliotibial friction band syndrome (more proximal).
How to evaluate joint stability?
When evaluating joint stability, the physician should perform a series of maneuvers to both the affected and unaffected knee to test the collateral and cruciate ligaments for laxity. The MCL is best evaluated with the patient supine by applying a valgus stress to the knee joint both with the knee in 30° of flexion and in full extension. The LCL can be assessed in a similar manner by applying a varus stress to the knee joint in 30° of flexion and full extension. By stressing the knee in flexion and extension, the clinician can test the collateral ligaments both in isolation and in combination with the secondary stabilizers of the knee. Laxity to valgus or varus stress with the knee in 30° of flexion indicates an isolated injury to the MCL or LCL, respectively. When laxity is also noted to varus or valgus stress with the knee in full extension, one or both cruciate ligaments are likely injured in addition to a collateral ligament [ 9 ]. The physical examination maneuvers utilized for the evaluation of the collateral ligaments are summarized in Table 2.1.
How to evaluate a PCL tear?
To test for this sign, the patient is positioned supine with 45° of hip flexion and 90° of knee flexion. In this position, the medial tibial plateau should sit approximately 1 cm anterior to the medial femoral condyle in a knee with an intact PCL. In the presence of a torn PCL, the tibial plateau will sag posteriorly resulting in a loss of this visible step-off and a positive posterior sag sign [ 7 ]. The posterior sag sign has been reported to have a sensitivity of 79 % and specificity of 100 % [ 19 ].
What is the range of motion of the knee?
The physician should evaluate both active and passive range of motion of the knee joint. Normal knee extension ranges from 0° to -10°, and normal knee flexion ranges from 130° to 150°. The patella should be observed for appropriate tracking with active and passive knee range of motion. Patellofemoral crepitus can often be observed with range of motion in the presence of patellofemoral osteoarthritis. Crepitus and/or pain in early flexion indicates more distal patella disease. Joint pain that is present during both active and passive range of motion is often associated with intra-articular pathology while pain that is present only with active range of motion has a higher likelihood of being related to an extra-articular soft tissue disorder [ 8 ].
Which ligaments are collateral stabilizers of the knee?
The posteromedial and posterolateral complexes of the knee are also important collateral stabilizers of the knee joint. The posterior oblique ligament and posteromedial joint capsule of the posteromedial complex prevent excessive anteromedial rotation, while the posterolateral complex (popliteus, fibular collateral ligament, popliteofibular ligament, fabellofibular ligament, arcuate complex, and lateral head of the gastrocnemius) prevents excessive posterolateral rotation. The anterior rotation drawer test and dial test are important maneuvers to determine whether pathology in these structures may exist.
How to test for ACL injury?
The anterior drawer test may also be used to assist with the identification of an ACL injury. In this test, the patient is positioned supine with the hip flexed at 45° and the knee flexed at 90°. The examiner places both hands on the proximal tibia with thumbs on the anterior tibial plateau and remaining fingers wrapped posteriorly. The lower extremity can be stabilized by sitting on the patient’s foot. An anterior translational force is then applied to the proximal tibia in relation to the femur. Analogous to the Lachman test, the anterior drawer test is positive for injury to the ACL injury when it results in a soft end point or increased anterior translation of the proximal tibia when compared to the unaffected side [ 9 ]. Reported sensitivity of this test is much more variable, ranging from 22.2 % to 95.24 % [ 12 – 17 ]. The specificity of the anterior drawer has been reported as greater than 97 % [ 14 ].
How to tell if a meniscus is torn?
A torn meniscus often can be identified during a physical exam. Your doctor might move your knee and leg into different positions, watch you walk and ask you to squat to help pinpoint the cause of your signs and symptoms.
What to do after meniscus surgery?
After surgery, you will need to do exercises to increase and maintain knee strength and stability. If you have advanced, degenerative arthritis, your doctor might recommend a knee replacement.
How does a knee splint work?
The device contains a light and a small camera, which transmits an enlarged image of the inside of your knee onto a monitor. If necessary, surgical instruments can be inserted through the arthroscope or through additional small incisions in your knee to trim or repair the tear.
How to help knee pain?
Ice can reduce knee pain and swelling. Use a cold pack, a bag of frozen vegetables or a towel filled with ice cubes for about 15 minutes at a time, keeping your knee elevated .
What is the best way to detect a torn meniscus?
MRI. This uses radio waves and a strong magnetic field to produce detailed images of both hard and soft tissues within your knee. It's the best imaging study to detect a torn meniscus.
How to strengthen knees?
Physical therapy can help you strengthen the muscles around your knee and in your legs to help stabilize and support the knee joint.
Can you have a knee replacement if you have arthritis?
If you have advanced, degenerative arthritis, your doctor might recommend a knee replacement. For younger people who have signs and symptoms after surgery but no advanced arthritis, a meniscus transplant might be appropriate. The surgery involves transplanting a meniscus from a cadaver.
How to protect knees while meniscus recovers?
One of the best ways to protect your knees while your meniscus recovers is to provide added support. That’s why I recommend, medical-grade knee compression sleeves because they help to reduce inflammation, increase support and protect your knees.
What does it mean when your meniscus is injured?
The first is an acute injury, meaning something suddenly caused the meniscus to tear, strain, or stress. This can include stepping out of the car wrong, landing in a strange position, or taking a fall.
What is the most common knee injury in meniscus tears?
Written by: Coach Todd. Meniscus tears are among the most common knee injuries in individuals 50 and over. It often leads to pain and a limited range of motion, yikes! Each of your knees has two C-shaped pieces of cartilage on either side of your knee cap that acts as a cushion between your shinbone and your thighbone.
Why does my knee hurt when I tear my meniscus?
When healthy, these menisci act like suction cups to keep your knee stable. And although lateral meniscus tears are less likely than medial tears, both injuries decrease the suction ability of the cartilage. This causes the knee to feel unstable and leads to pain.
How do you know if you have a meniscus tear?
If you notice that one knee doesn’t fully straighten or if it is painful to try and push down on it , this another indication you have a knee meniscus tear.
How long does it take for a meniscus tear to heal?
This could take anywhere from 4–8 weeks depending on the severity and position of the tear.
Why does my meniscus tear?
The other cause of meniscus tears occurs through chronic injuries, such as arthritis. Arthritis causes wear and tear on the joints, causing the connective tissue (aka the meniscus) to slowly wear out.
How to tell if you tore your meniscus?
If you've torn your meniscus, you might have the following signs and symptoms in your knee: 1 A popping sensation 2 Swelling or stiffness 3 Pain, especially when twisting or rotating your knee 4 Difficulty straightening your knee fully 5 Feeling as though your knee is locked in place when you try to move it 6 Feeling of your knee giving way
What is a torn meniscus?
Torn meniscus. The meniscus is a C-shaped piece of tough, rubbery cartilage that acts as a shock absorber between your shinbone and thighbone. It can be torn if you suddenly twist your knee while bearing weight on it. A torn meniscus is one of the most common knee injuries.
What happens if you twist your knee?
A torn meniscus causes pain, swelling and stiffness.
What does it mean when your knee is popping?
A popping sensation. Swelling or stiffness. Pain, especially when twisting or rotating your knee. Difficulty straightening your knee fully. Feeling as though your knee is locked in place when you try to move it. Feeling of your knee giving way.
Can a torn meniscus be caused by a squat?
A torn meniscus can result from any activity that causes you to forcefully twist or rotate your knee, such as aggressive pivoting or sudden stops and turns. Even kneeling, deep squatting or lifting something heavy can sometimes lead to a torn meniscus. In older adults, degenerative changes of the knee can contribute to a torn meniscus ...
Can a torn meniscus be a risk?
Performing activities that involve aggressive twisting and pivoting of the knee puts you at risk of a torn meniscus. The risk is particularly high for athletes — especially those who participate in contact sports, such as football, or activities that involve pivoting, such as tennis or basketball.
How to test if you have a meniscus tear?
To test your ability to extend the leg, sit in a hard chair with your feet flat on the floor. Then, try to raise your foot until your leg is straight and the foot is stretched in front of you. If you are not able to straighten your leg, you have most likely torn the meniscus.
How to tell if a meniscus tear is a ligament?
When the ligament is intact, your knee bends smoothly. However, after you tear your meniscus, the injured tissue sticks up, catching as you move .
What happens if you twist your knee?
If you twisted your knee while participating in a sporting event and have started having symptoms, you may have a tear in your meniscus, the ligament that connects your thighbone to your knee cap. Look for the four early warning signs below that you have a torn meniscus.
What to do if your knee cap is red?
Along with the swelling, you may experience redness around your knee cap. You may also notice that the skin feels warmer than the rest of your leg. Again, these symptoms are part of your body’s immune response to try to fix the problem itself. If you experience swelling, elevate your leg and apply ice.
Why does my knee swell up?
This swelling occurs because your body’s immune system has received the signal that the area is injured. When the body responds, it sends extra blood, lymph, and cells to begin work on repairing the tear.
How to stop knee pain from moving?
Rest helps reduce the pain, as well as applying ice. If you must move around, avoid any sharp, jerky motions that could increase your pain or further injure the knee.
How to test if you can extend your leg?
You also risk tearing the ligament even further. To test your ability to extend the leg, sit in a hard chair with your feet flat on the floor.
How to preserve meniscus?
The goal of surgery is to preserve the meniscus by repairing or removing the torn part. The procedure is typically done arthroscopically, meaning a small camera is inserted into a tiny incision in the knee to guide the surgeon in repairing or removing the tear using small instruments inserted into another tiny incision.
How to treat a torn meniscus?
The first step in treating a torn meniscus is getting the injury examined by a physician who specializes in orthopedics. During the exam, they may check the tenderness of your knee joint and move your leg to get a measure of your knee’s range of motion.
How to heal a tear?
Non-surgical treatment for tears that can heal on their own may include: 1 Physical therapy 2 RICE: Rest, Ice, Compression, Elevation 3 Anti-inflammatory medications
How many meniscus wedges are there in each knee?
Each of your knees has two meniscus wedges. Meniscus tears are common among athletes, especially those who play sports that require a lot of squatting, twisting, and changing positions. You will feel a pop when your meniscus is torn. Afterward, you may experience:
What happens if you bend your knee?
Pain in the knee joint that comes and goes and gets worse when putting pressure on the joint. The feeling that your knee is giving way, locking, or catching when you bend it. If not treated, part of the meniscus may come loose and slip into the joint. You may need surgery to restore full knee function.
Can a meniscus tear cause arthritis?
Not necessarily. Left untreated, a meniscus tear can limit your daily life and ability to participate in exercise and sports. In serious cases, it can develop into long-term knee problems, like arthritis. In addition moving around with a torn meniscus could pull fragments of the cartilage into the joint causing larger knee issues which could ...
Can a meniscus tear be a knee injury?
While some athletes — including those who play contact sports — are especially at risk for meniscus tears, this injury is one of the most common knee injuries. And anyone can suffer from them, regardless of age or activity.
How to diagnose a meniscus tear?
Treating a meniscus tear. The first step in diagnosing a meniscus tear is to get an x-ray of the knee to be sure there is no fracture or boney abnormalities. If there is a lot of swelling in the knee, we often will recommend getting an MRI to assess the meniscus. Once we know what the problem is we can offer treatment.
How do you know if you have a torn meniscus?
If you suspect a torn meniscus there are four symptoms that are commonly experienced in people with this injury: Individuals with a meniscus tear often complain of pain along the joint line. They often have pain or weakness with bending the knee and sometimes they have a catching or locking sensation. With an acute tear, individuals may notice ...
What is the cartilage that lives in the knee?
The Meniscus is the cartilage that lives in the knee and acts as a cushion between the tibia and femur. It is a C-shaped structure that is located on both the outside and inside of the knee. The meniscus provides 50% of the weight bearing in the joint.
Why do meniscus tears happen?
Sometimes additional weight can cause increased stress across the meniscus and as people age it may put them at a higher risk of a meniscus tear because the tissue quality is poor or weak.
How long does it take to heal a meniscus tear?
We can also treat these types of meniscus injuries with anti-inflammatories and physical therapy. For acute tears, we may start with 6 – 8 weeks of physical therapy. If the symptoms do not resolve with physical therapy, we often will recommend surgery in younger patients, especially those who have an athletic tear.
Where does a medial tear occur?
A Lateral tear – This type of tear happens along the outside edge of the knee. A Medial tear – This type of tear is on the inside of the knee and it is often associated with deep knee flexion. A Meniscal Root tear – A tear at the root of the meniscus where it inserts into the bone – either in the front – the anterior root or the back ...
Can a meniscus tear be a fall?
There are two ways that people end up with a meniscus tear. First, they can experience an acute tear from a fall or an athletic injury. Sports with a lot of rotation or twisting, and deep knee bends can put individuals at greater risk. With the advent of an acute tear, people usually experience, swelling, pain and limited range ...
Diagnosis
- A torn meniscus often can be identified during a physical exam. Your doctor might move your knee and leg into different positions, watch you walk, and ask you to squat to help pinpoint the cause of your signs and symptoms.
Treatment
- Treatment for a torn meniscus often begins conservatively, depending on the type, size and location of your tear. Tears associated with arthritis often improve over time with treatment of the arthritis, so surgery usually isn't indicated. Many other tears that aren't associated with locking or a block to knee motion will become less painful over time, so they also don't require surgery. Yo…
Lifestyle and Home Remedies
- Avoid activities that aggravate your knee pain — especially sports that involve pivoting or twisting your knee — until the pain disappears. Ice and over-the-counter pain relievers can be helpful.
Preparing For Your Appointment
- The pain and disability associated with a torn meniscus prompt many people to seek emergency care. Others make an appointment with their family doctors. Depending upon the severity of your injury, you might be referred to a doctor specializing in sports medicine or a specialist in bone and joint surgery (orthopedic surgeon).