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- Ege’s test
- Meniscus tears
- Meniscus AND Ege’s test
- Ege’s test
- Meniscus tears
- Meniscus AND Ege’s test
The purpose of the test is to detect a meniscus tear. It’s also called the weight-bearing Mc Murray test because when patients perform this test, they have to put weight on their knees. Depending on the meniscus we want to investigate, the patient’s feet are turned outwards (medial meniscus) or inwards (lateral meniscus). 
Clinically Relevant Anatomy
Art. Genus consists of a number of anatomical structures and the menisci are a part of those structures. We have two menisci, a lateral and a medial. These cover the tibial articular surfaces.
The medial meniscus is larger than the lateral meniscus and has a C shape. This will combine with the Lig. Collaterale Mediale.
The lateral meniscus is smaller than the medial meniscus and has an O-shape. This is more mobile than the medial meniscus and will combine with the M. Popliteus 
The Ege's test is a test where the patient is going to put weight on both knees and is performed in a standing position.
The starting position:
- the knees are in extension
- the patient stands with his feet 30-40cm apart
- Depending on the meniscus (medial or lateral) you wanna studie, the position the patient's feet are maximum external rotation (medial meniscus) or maximum internal rotation (lateral meniscus). 
For Medial meniscus tears, the patient squats with both lower legs in maximum external rotation (perfrom a squat) and then stands up slowly. The distance between the knees increases and each knee becomes externally rotated as the squatting proceeds.  By performing the squat in maximum external rotation, there will be created a varus stage (knees point outward). Patient goes so far as possible and then return to the starting position (extension of the knee) 
To detect a Lateral meniscus tear, both lower extremities are held in maximum internal rotation while the patient squats and stands up. A complete squat in full Internal rotation is rarely possible, even for healthy knees, therefore the patient is allowed to steady themselves for a slightly less than full squat. In contrast to the medial meniscus test, the distance between the knees decreases and the knees become internally rotated as the squatting proceeds.  By performing the squat in maximal internal rotation will create a valgus position (knees point inward). Patient goes so far as possible and then return to the starting position (extension of the knee). 
The test is positive when pain and/or a click is felt by the patient at the related site of the joint line. Further squatting is stopped as soon as the pain and/or click is felt. Hereby a full squat is not needed in all of the patients. Sometimes pain and/or click may not be felt until maximum squat, but may be felt as the patient comes out of the squat, which is also a positive sign of the test. Pain and/or click are felt at around 90° of knee Flexion.  
- It is important that during the test both feet stay on the ground.
- It is important that the maximum rotation is maintained throughout the squat 
- These movements can not be fully performed by healthy people, so first it is important that the patient doesn’t perfrom the squat fulley to prevent from hurting. Secondly, it is important that the patient may take support anywhere (eg on the treatment table). 
Anteriorly located tears produce the symptoms in earlier knee flexion, whereas tears located on posterior horn of the menisci produce the symptoms in more knee flexion.
Flexion-extension, and internal-external rotation components of the test are similar to that of McMurray’s test. However, the most important difference is the weight-bearing position of the patient. The test may also be called the Weight-bearing McMurray’s test. Varus and valgus stress is also produced during internal and external rotation positions. 1
(A) To detect a medial meniscal tear, both lower extremities are held in maximum external rotation.
(B) The patient then squats in this position.
(C) For lateral meniscal tears, both lower extremities are held in maximum internal rotation.
(D) Maximum internal rotations of both lower extremities are preserved during squatting.
| N (Akseki et al.)|| effected side|| accuracy|| sensitivity|| specificity|| pos. liklihood|| neg. likelihood|| total % of wrong predictions|
| 211|| med|| 0,71|| 0,67|| 0,81|| 3,5|| 0,4|| 26%|
| || lat|| 0,84|| 0,64|| 0,90|| 5,3|| 0,5|| 21%|
| || || || || || || || M = 24% ± 2,55|
According to Akseki et al. (B) the test correlated well to arthroscopic findings with a 0,341 kappa score. Akseki et al. compared diagnostic values of the Ege’s test with McMurray’s test and Joint line tenderness. There were no statistically significant differences found between the 3 tests in detecting a meniscus tear ( p > 0,05). However, for medial meniscus tears, Ege’s test scored better accuracy, sensitivity, and specificity rates with respectively 0,71, 0,67 and 0,81. For lateral meniscus tears Ege's test gave results superior to the others: 0,84 accuracy, 0,64 sensitivity and 0,90 specificity. Ege’s test is more specific than sensitive. 
Looking at the different types of Meniscal tears, Akseki et al. found that degenerative tears of the medial menisci were missed in 66% (8 of 12!). Medial menisci were diagnosed correctly with Ege’s test in 84% of cases, compared to only 61% with McMurray’s test. Similarly, Ege’s test was better at diagnosing longitudinal and bucket-handle medial meniscal tears.
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- ↑ D Akseki, O Ozcan, H Boya, and H Pinar. A new weight-bearing meniscal test and a comparison with McMurray's test and joint line tenderness. Arthroscopy, The Journal of Arthroscopic & Related Surgery; Nov 2004; 20(9): 951-958.
- ↑ McKeon B, Bono J, Richmond J. Knee Arthroscopy. Springer; 2009: 202 (1, 2, 12, 43)
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 Akseki D, Özcan Ö, Boya H, Pınar H. New Weight-Bearing Meniscal Test and a Comparison With McMurray’s Test and Joint Line Tenderness. Arthroscopy: The Journal of Arthroscopic and Related Surgery 2004; Vol 20; 9:951-958
- ↑ 4.0 4.1 4.2 4.3 Hegedus EJ, Cook C, Hasselblad V, Goode A, McCrory DC. Physical examination tests for assessing a torn meniscus in the knee: a systematic review with meta-analysis. J Orthop Sports Phys Ther. 2007 Sep;37(9):541-50.
- ↑ 5.0 5.1 5.2 5.3 5.4 Hing W, White S, Reid D, Marshall R. Validity of the McMurray's Test and Modified Versions of the Test: A Systematic Literature Review. The Journal of Manual &amp; Manipulative Therapy [2009, 17(1):22-35]
- ↑ 6.0 6.1 6.2 6.3 Manish Pruthi MS DNB, Ravi K Gupta MS DNB MNAMS FIMSA, Akshay Goel MS. Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India. Current concepts in meniscal injuries.
- ↑ 7.0 7.1 7.2 Daniel Bossen and Marcel Jurad. The Accuracy of Physical Examination Techniques in Diagnosing Meniscus Lesions. A Systematic Review
- ↑ 8.0 8.1 Dan Lorenz, MS, PT, ATC/L, CSCS, KPTA Research Committee Member. Literature Review: CLINICAL TESTS FOR MENISCUS LESIONS.
- ↑ Hedgedus EJ, Cook C, Hasselblad V, Goode A, McCrory DC. Physical examination tests for assessing a torn meniscus in the knee: a systematic review with meta-analysis. Journal of Orthopadedic and sports physical therapy; 2007; 37(9): 541 – 550
- ↑ 10.0 10.1 10.2 10.3 10.4 10.5 10.6 Blok B, Cheung D, Fortescue Platts-Mills T. First Aid for the Emergency Medicine Boards. The McGraw-Hill Companies; 2009: 935 (216)