History and exam
Key diagnostic factors
common
history of knee trauma
Traumatic meniscal tears most commonly occur in young, active people, usually as a result of trauma sustained during pivoting or twisting sports such as American football, soccer, rugby, and basketball.[12] Skiers, runners, and tennis players are also at risk. Twisting with joint compression puts the soft tissue meniscus at risk of tearing.
Anterior cruciate ligament injury leads to knee instability, which in turn leads to abnormal motions in the knee and abnormal sheer stresses, both of which can tear the meniscus cartilage.
history of knee arthritis, instability, or malalignment
Degenerative meniscal tear can occur as a result of traumatic and degenerative arthritis.
Instability of the knee leads to abnormal motions in the knee and abnormal shear stresses, both of which can tear meniscus cartilage.
Malalignment of the knee places abnormal compression and rotational forces on one side of the joint versus the other, thus increasing the possibility of tearing the meniscus.
knee swelling
Usually occurs several hours after injury, but is not always present.
sensation of knee instability or buckling/catching
Patient often describes sensation of femur and tibia twisting apart from each other (catching or locking) or the knee feeling loose.
knee pain
Varies greatly. Some experience minimal pain, while others describe intermittent pain.
tenderness at joint line and joint line crepitation
Often due to unstable meniscus tissue and abnormal force transmission.
Other diagnostic factors
common
popliteal (Baker) cyst in chronic cases
Swelling at the posterior aspect of the knee suggests a popliteal (Baker) cyst. Popliteal cysts are associated with meniscal pathology in 80% of cases.[24] See Popliteal cyst for more information.
limited range of motion
Full flexion and extension may or may not be lacking.
Risk factors
strong
acute trauma (pivoting or twisting injury)
Traumatic meniscal tears most commonly occur in young, active people, usually as a result of trauma sustained during pivoting or twisting sports such as American football, rugby, soccer, and basketball.[12] Skiers, runners, and tennis players are also at risk. Twisting with joint compression puts the soft tissue meniscus at risk of tearing.
knee joint arthritis
Degenerative meniscal tear can occur as a result of traumatic and degenerative arthritis.
knee instability
Leads to abnormal motions in the knee and abnormal shear stresses, both of which can tear meniscus cartilage.
history of anterior cruciate ligament injury
Leads to knee instability, which in turn leads to abnormal motions in the knee and abnormal shear stresses, both of which can tear meniscus cartilage.
malalignment of the knee joint
Places abnormal compression and rotational forces on one side of the joint versus the other, thus increasing the possibility of tearing the meniscus.
rough or uneven playing surface
It is suggested that increased friction from various sporting turfs may lead to a meniscal tear.
poor ground/weather conditions
Poor conditions with snow, sleet, or rain increase the likelihood of slips, falls, and improper landings, all increasing the risk of a meniscal tear.[15]
weak
construction work and manual labor jobs
These occupations usually involve knee flexion while lifting heavy objects, as well as excessive kneeling or squatting, thereby putting stress on the joint and increasing the risk of meniscal tearing.[12]
discoid meniscus
This fails to undergo complete condensation into physiologic dimensions and may either lack an attachment to stabilize the posterior horn to the tibia or be discoid in form with normal attachment.
The incidence of discoid menisci is higher in the Asian population.[20] Discoid lateral meniscus is found in 3.5% to 5% of meniscal tear patients.[16]
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