Which test would be most likely to indicate a lateral meniscus tear when internal rotation is used during knee flexion?

• A. McMurray's test with internal rotation
• B. Apley compression test
• C. Thessaly test
• D. Lachman test

Answer: (A)

Rotating the tibia while the knee is flexed is used to stress the two menisci differently and provoke a tear. Internal rotation of the tibia during knee flexion tends to stress and reveal injuries of the medial meniscus, while external rotation stresses the lateral meniscus. So, to indicate a lateral meniscal tear, the maneuver would more typically involve external rotation (as in McMurray’s test with external rotation) to reproduce a painful click or reproduce mechanical symptoms. Internal rotation is not the most sensitive way to detect a lateral tear because it primarily loads the medial meniscus.

Apley compression test can indicate meniscal pathology in general but isn’t specific to which meniscus. The Thessaly test is a dynamic, weight-bearing test for meniscal tears but isn’t about stressing one side with rotation in the same way. Lachman test, on the other hand, checks ACL integrity, not the menisci. So the direct way to implicate the lateral meniscus is to use McMurray’s with external rotation, not internal rotation.