Diagnostic value of history-taking and physical examination for assessing meniscal tears of the knee in general practice

Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine
Harry P A WagemakersSita M A Bierma-Zeinstra

Abstract

To assess the diagnostic value of history-taking and physical examination of meniscal tears in general practice. An observational study determining diagnostic values (sensitivity, specificity, predictive value, and likelihood ratios). General practice. Consecutive patients aged 18 to 65 years with a traumatic knee injury who consulted their general practitioner within 5 weeks after trauma. Participating patients filled out a questionnaire (history-taking) followed by a standardized physical examination. Assessment of meniscal tears was determined by means of magnetic resonance imaging (MRI) and was performed blinded for the results of physical examination and history-taking. Of the 134 patients included in this study, 47 had a meniscal tear. From history-taking, the determinants "age over 40 years," "continuation of activity impossible," and "weight-bearing during trauma" indicated an association with a meniscal tear after multivariate logistic regression analysis, whereas from physical examination only "pain at passive flexion" indicated an association. These associated determinants from history-taking showed some diagnostic value; the positive likelihood ratio (LR+) reached up to 2.0 for age over 40 years, whereas the isolate...Continue Reading

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