Thessaly Test | Meniscus Tear Assessment | Meniscus Injury

The Thessaly test has been described as the most accurate test for meniscus lesions by Karachalios et al. (2005). However, there has been new research by Goosens et al.(2015) with a higher quality that states that the sensitivity is as low as 64% and the specificity is as low as 53%. This means that the Thessaly Test is not an accurate test to detect meniscus lesions. However, the Apley’s Test or the McMurray Test do not perform much better in this regard. So when you suspect a meniscus lesion from your patient history taking, you can still perform those tests, but eventually, you might want to send your patient to get an MRI.

Like with any provocative test, you first want to test the uninjured leg, before you move on to the injured leg. To perform this test, have your patient stand on the injured leg which is flexed to 20°. Your patient may hold onto your arms for support. Then rotate over the tibia three times on each side. This test is positive if your patient is complaining about pain in the joint line during the rotations.

21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE

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Other common tests to assess for meniscus injuries are:

• McMurray Test
• Joint Line Tenderness
• Ege’s Test
• Apley’s Test
• Duck Walk Test
• Finochietto Test

References

Smith BE, Thacker D, Crewesmith A, Hall M. Special tests for assessing meniscal tears within the knee: a systematic review and meta-analysis. BMJ Evidence-Based Medicine. 2015 Jun 1;20(3):88-97.

Goossens P, Keijsers E, Van Geenen RJ, Zijta A, Van den Broek M, Verhagen AP, Scholten-Peeters GG. Validity of the Thessaly test in evaluating meniscal tears compared with arthroscopy: a diagnostic accuracy study. journal of orthopaedic & sports physical therapy. 2015 Jan;45(1):18-24.

Karachalios T, Hantes M, Zibis AH, Zachos V, Karantanas AH, Malizos KN. Diagnostic accuracy of a new clinical test (the Thessaly test) for early detection of meniscal tears. JBJS. 2005 May 1;87(5):955-62.