Ege's Test for Meniscus Tear

Modified or Weight-Bearing McMurray's Test

knee examination
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Ege's test is a specific maneuver to detect a meniscus tear. It mimics the mechanism that most often results in meniscus tears. In this test, the patient applies force to his knee through a squatting movement and the examiner listens and feels for a click due to the torn piece of cartilage being caught between the bones. It is also known as a modified McMurray test or a weight-bearing McMurray test.

This test was developed by Dr. Ridvan Ege in 1968. When a meniscus tear is suspected, this is a test that might be used to help decide whether or not to scope the knee.

How Ege's Test Is Performed

The patient stands up, with knees extended and feet about a foot apart (30 to 40 centimeters).

To test for a suspected medial meniscus tear, the patient is asked to turn his feet outward, externally rotating the knee. He then squats and slowly stands back up. The patient and examiner are alert for an audible and/or palpable click or pain in the area of the meniscus.

To test for a lateral meniscus tear, the patient turns his feet inward to maximum internal rotation of the knee. The patient squats and then slowly stands up. The patient and examiner are alert for the click or pain in the area of the meniscus.

Usually, pain or a click will be felt when the knee is flexed at about 90 degrees. The patient can use support if needed, since often even healthy people can't do the squats requested without support.

A positive test of click or pain points towards a meniscus tear.

Tests to Detect a Meniscus Tear

The patient is examined lying down with these two common tests:

  • McMurray's Test
    McMurray's test is similar to Ege's test, but the patient is lying down (non-weight bearing) and the examiner bends the knee. The click is felt over the meniscus tear as the knee is brought from full flexion to 90 degrees of flexion. The patient may also experience pain along with the click. This test is not very sensitive but is relatively specific for a meniscus tear.
  • Joint Line Tenderness
    Joint line tenderness is a very non-specific test for a meniscus tear. The area of the meniscus is felt, and a positive test is considered when there is pain over the area where the meniscus is found. This test is both non-specific and not very sensitive.

What Is the Best Test for a Meniscus Tear?

Studies have looked at all three tests for detecting a meniscus tear. No one test was significantly better than the other test, but the authors found that the addition of Ege's test can help increase the accuracy of diagnosing a meniscus tear. An arthroscopic examination and MRI may be needed to determine whether there is a meniscus tear.

Source:

Hing W, White S, Reid D, Marshall R. Validity of the McMurray's Test and Modified Versions of the Test: A Systematic Literature Review. Journal of Manual & Manipulative Therapy. 2009;17(1):22-35. doi:10.1179/106698109790818250.

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