Which physical examination test is described as having the patient stand on the affected leg with the knee flexed about 20 degrees and the knee rotated internally and externally three times, with a positive result indicated by locking, catching, or joint-line pain?

Which physical examination test is described as having the patient stand on the affected leg with the knee flexed about 20 degrees and the knee rotated internally and externally three times, with a positive result indicated by locking, catching, or joint-line pain?

• A. Apley compression test
• B. Lachman test
• C. McMurray test
• D. Thessaly test

Answer: (D)

Thessaly test. This maneuver specifically targets meniscal pathology by combining weight-bearing and knee rotation at a shallow flexion. When the knee is bent about 20 degrees and you stand on the affected leg, rotating the tibia internally and externally creates shear and compression across the menisci. If a tear is present, the torn fragment can catch or pinch between the femur and tibia, producing locking, catching, or joint-line pain. Repeating the rotation for a few cycles increases the likelihood of provoking symptoms, hence a positive result. This approach differs from other meniscal tests because it uses dynamic, weight-bearing loading at a low degree of flexion, which more closely mimics the stresses that reveal a torn meniscus in daily activities. Apley compression is performed with the patient prone at 90° and uses compression with rotation; Lachman assesses ACL laxity; McMurray involves non-weight-bearing knee flexion/extension with rotation to elicit a click. The Thessaly test’s key feature is the combination of standing, slight knee bend, and rotational movement to provoke meniscal irritation. A positive test is the presence of locking, catching, or sharp joint-line pain.

Thessaly test. This maneuver specifically targets meniscal pathology by combining weight-bearing and knee rotation at a shallow flexion. When the knee is bent about 20 degrees and you stand on the affected leg, rotating the tibia internally and externally creates shear and compression across the menisci. If a tear is present, the torn fragment can catch or pinch between the femur and tibia, producing locking, catching, or joint-line pain. Repeating the rotation for a few cycles increases the likelihood of provoking symptoms, hence a positive result.

This approach differs from other meniscal tests because it uses dynamic, weight-bearing loading at a low degree of flexion, which more closely mimics the stresses that reveal a torn meniscus in daily activities. Apley compression is performed with the patient prone at 90° and uses compression with rotation; Lachman assesses ACL laxity; McMurray involves non-weight-bearing knee flexion/extension with rotation to elicit a click. The Thessaly test’s key feature is the combination of standing, slight knee bend, and rotational movement to provoke meniscal irritation. A positive test is the presence of locking, catching, or sharp joint-line pain.