Apley’s Test (Knee) – Physical Exam

Apley’s test involves placing the patient in the prone position with the knee flexed to 90 degrees. The patient’s thigh is then rooted to the examining table with the examiner’s knee. The examiner laterally and medially rotates the tibia, combined first with distraction, while noting any excessive movement, restriction or discomfort. The process is then repeated using compression instead of distraction. If rotation plus distraction is more painful or shows increased rotation relative to the normal side, the lesion is most likely to be ligamentous. If the rotation plus compression is more painful or shows decreased rotation relative to the normal side, the lesion is most likely to be a meniscus injury.

Another test to assess for meniscus damage is  McMurray Test

Reliability of The Test

Many studies have attempted to quantitate the reliability of various physical examination findings. In a prospective study comparing preoperative joint line tenderness to arthroscopic findings of meniscal tears, the sensitivity of joint line tenderness was found to be 86% and 92% with an overall accuracy rate of 74% and 96% for the medial and lateral meniscus, respectively, another study found similar results, with joint line tenderness having a sensitivity of 74%. The only significant McMurray sign to correlate with a meniscal injury was a “thud” elicited on the medial joint line with a medial meniscal tear. However, the McMurray and Apley tests were found by others to have less than 75% sensitivity for diagnosing meniscal tears.

Reference:
– Link 1

Kai demonstrates the Apley’s Test for meniscus damage. Be sure to watch the McMurray and Thessaly Test at the end of the video or click on the “i” in the top right corner.

Article: http://www.ncbi.nlm.nih.gov/pubmed/26243431

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