American Board of Internal Medicine (ABIM) Certification Practice Exam

Which physical exam finding is associated with acute meniscal injuries?

1. Positive Mcmurray test

2. Positive Thessaly and medial-lateral grind tests

3. Knee extension impairment

4. Tenderness over the iliotibial band

The correct answer is: Positive Thessaly and medial-lateral grind tests

The positive Thessaly and medial-lateral grind tests are indeed associated with acute meniscal injuries. The Thessaly test involves the patient standing on one leg, bending the knee slightly, and rotating the trunk, which stresses the meniscus. A positive result indicates pain or a sensation of locking or catching, suggesting a meniscal tear. Similarly, the medial-lateral grind test, or the "grind test," applies pressure on the knee while moving it in a flexing and extending motion, which may also provoke pain if there is a meniscal injury. These specific tests are designed to elicit symptoms that are characteristic of meniscal damage, making them reliable indicators in the assessment of acute meniscal injuries. The other physical exam findings mentioned do not specifically correlate with acute meniscal injuries in the same way. For instance, while a positive McMurray test is known for assessing meniscal tears, it is not as directly associated with acute injuries compared to the Thessaly and grind tests. Knee extension impairment can occur with a variety of knee issues, not exclusively meniscal injuries, and tenderness over the iliotibial band is more indicative of iliotibial band syndrome, which is not related to the meniscus directly.