TY - JOUR T1 - Special tests for assessing meniscal tears within the knee: a systematic review and meta-analysis JF - Evidence Based Medicine JO - Evid Based Med SP - 88 LP - 97 DO - 10.1136/ebmed-2014-110160 VL - 20 IS - 3 AU - Benjamin E Smith AU - Damian Thacker AU - Ali Crewesmith AU - Michelle Hall Y1 - 2015/06/01 UR - http://ebm.bmj.com/content/20/3/88.abstract N2 - Background Musculoskeletal knee pain is a large and costly problem, and meniscal tears make up a large proportion of diagnoses. ‘Special tests’ to diagnose torn menisci are often used in the physical examination of the knee joint. A large number of publications within the literature have investigated the diagnostic accuracy of these tests, yet despite the wealth of research their diagnostic accuracy remains unclear. Aim To synthesise the most current literature on the diagnostic accuracy of special tests for meniscal tears of the knee in adults. Method An electronic search of MEDLINE, Cumulative Index to Nursing and Allies Health Literature (CINAHL), The Allied and Complementary Medicine Database (AMED) and SPORTDiscus databases was carried out from inception to December 2014. Two authors independently selected studies and independently extracted data. Methodological quality was evaluated using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS) 2 tool. Results Nine studies were included (n=1234) and three special tests were included in the meta-analysis. The methodological quality of the included studies was generally poor. McMurray's had a sensitivity of 61% (95% CI 45% to 74%) and a specificity of 84% (95% CI 69% to 92%). Joint line tenderness had a sensitivity of 83% (95% CI 73% to 90%) and a specificity of 83% (95% CI 61% to 94%). Thessaly 20° had a sensitivity of 75% (95% CI 53% to 89%) and a specificity of 87% (95% CI 65% to 96%). Conclusions The accuracy of the special tests to diagnose meniscal tears remains poor. However, these results should be used with caution, due to the poor quality and low numbers of included studies and high levels of heterogeneity. The authors are grateful to Arthritis Research UK and the Chartered Society of Physiotherapy Charitable Trust for providing the funding for BES to complete this study. ER -