Purpose: Identify patients who likely have meniscal pathology based on specific patient characteristics and examination findings.
Rule:
1. History of catching or locking reported by the patient
2. Joint line tenderness
3. Pain with forced hyperextension (modified bounce home test)
4. Pain with maximal passive knee flexion
5. Pain or audible click with McMurray manuver
| Item | 3+ variable | 4+ variables | 5 variables |
| SN | 0.31 | 0.17 | 0.11 |
| SP | 0.9 | 0.96 | 0.99 |
| +LR | 3.14 | 4.28 | 11.2 |
| -LR | |||
| PPV | 77% | 82% | 92% |
| NPV |
SN = sensitivity – ‘SnOut’ helps rule out a disease (higher number is better – >0.9 is excellent)
SP = Specificity – ‘SpIn’ helps rule in a disease (higher number is better – greater than 0.90 is excellent))
+LR = positive likelihood ratio – ratio of positive test results in a patients with the pathology (true positives) higher number is better (> 10 is excellent)
-LR = negative likelihood ratio – ratio of negative test results in a patients with the pathology (false negatives) lower number is better (< 0.1 is excellent)
PPV = positive predictive value – percentage of patients who both test positive & have the disease (true positives)
NPV = negative predictive value – percentage of patients who both test negative & do not have disease (true negatives)
References:
1. Lowery DJ, et al. A clinical composite score accurately detects meniscal pathology. Arthroscopy. 2006; 22(11): 1174-9.
