Hips

Thessaly’s Test has good diagnostic accuracy for early detection of meniscal lesions

Currently, the clinical tests we use to detect early meniscal lesions have variable diagnostic accuracy.  A few years ago, the Journal of Bone and Joint Surgery published a study which examined the diagnostic accuracy of a new, functional meniscal test, The Thessaly’s test.  The results of this study indicated that the Thessaly’s test, performed in 20 degrees of knee flexion, had a diagnostic accuracy of 94% in detection of medial meniscal tears and 96% in detection of lateral meniscal tears. Other, more traditional tests, performed in this study, had much lower detection rates.

How to perform: The patient stands on a single leg (the effected leg) with their knee bent to 20 degrees.  The examiner helps support them with UE support.  The patient then rotates his/her knee internally and externally.  Complaints of pain, knee locking or catching is considered a + test.

Theory of how it works:  With this maneuver, the meniscal tear is subjected to excessive loading conditions.

Medial Menscus Detection Sensitivity: 89%  Specificity: 92%   Accuracy: 94%

Lateral Meniscus Detection Sensitivity: 97%      Specificity: 96%     Accuracy: 96%

(Note: This test can also be performed in 5 degrees of knee flexion with lower diagnostic accuracy)

Karachalios T, Hantes M, et al.  Diagnostic accuracy of a new clinic test (the Thessalay test) for early detection of meniscal test. Journal of Bone and Joint Surgery 2005; 87: 955-962.

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3 replies »

  1. Thank you for clear, concise information – if only one of the GPS I went to for help had known about injuries – I was left to struggle in agony with muscle, tendon and ligament fibres in my legs being torn on a daily basis as I had to struggle to walk back and forth taking and collecting my children to and from school. My legs and feet were grossly swollen and chronically inflamed, a bloodied bruise area appeared on the lower calf of my right leg. The agony was unbearable but I am a single parent and had no choice but to struggle on. I could not wear shoes due to the pain and swelling, this caused callouses on the undersides of my feet, my feet were full of fluid and felt ‘squelchey’ to stand/walk on. My lower legs felt ‘sloppy’ and out of control but all I received from the health service was insults and I was told not to hobble. I then felt something clicking and moving in the back of my right knee (medial). Ma2010 I managed to find a chiropractor who gaveme relevant advi and was the first person to mention injuries. I sent his report to the musculoskeletal ‘consultant’ but heard nothing further about it. Finally, August 2010, 14 months after my first visit to a GP about my agonies, I was given an MRI, but only for one knee, apparently because of cost. I now have inabilities, torn cartilages in both knees, haven’t been able to work because of the pain ( now minimal unless I walk a way), I have lost three years quality of life with my children, the NHS have written various insults about my family, we were denied disability help – I am so depressed and we have lost hope for our future. Aren’t GPs taught about injuries? We have no healthcare here now. Apparently I wasn’t worth the effort or the cost.

  2. In response to GP’s and injuries: Generally, doctors are so specialized these days that you will likely be referred to an orthopedic specialist for further testing. Some GP’s will also refer you to a physical therapist who is trained in these tests/evaluations. I’d highly recommend going to a PT if you can; but, I’m a little biased as I am one.

    • Dear Mike,

      Thank you so much for taking the trouble to reply to my message – I really appreciate your message, and if only the GP had considered me worthy of healthcare possibly I would have been referred, unfortunately for me the GPs in this area did not, and do not, believe I was/am important enough and I was left to struggle in agony with the injuries worsening. There was/is no physio/sports injury clinic here so I was reliant on the local GPs (I had no transport and we were new to the area/region). There are various insulting personal remarks written in my Notes and I have had to put up with humiliation. I have not been able to play with my children or work, I am very much better than I was, but have unnecessary injuries now. We have no GP here now because I don’t trust in the NHS anymore and I am heartbroken that the NHS staff here believed it acceptable to write such hurtful and unjustified remarks in my Records. I want to have the good health I had when we first moved here, but I don’t know if I can return to usual ability. The experience has been devastating physically, financially and emotionally – I have never before met anyone who cared so little about the pain and harm caused to myself, and I am completely devastated that anyone would believe it acceptable to write irremovable insults about myself and my children. The GPs here, by the way, did not examine me – I was first given appointments with newly-qualified or trainee GPs and I think this has continued. There seem to have been a variety of ‘guesses’ at what might have been wrong and words such as ‘surprisingly there seems to be no …’. think I’ve been used for practice instead of being treated, and I have been left to suffer in agony and with problems I don’t know will heal. I don’t understand how any decent, caring person could put someone through the pain and the misery I have been left to suffer.

      I do appreciate your taking the time to reply to my posting – I hadn’t known you had sent a message. Thank you again,

      Sue

      I I I , ?

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