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- Dr. Amy Cannatta and Ashley Baratko review how to tell if you have an ACL tear or a meniscus injury at home.
It helps to know what you were doing when your knee started hurting. Ligament tears like the ACL tear are more often injuries suffered during sports. Meniscal injuries are more often a series of tiny tears that occur more gradually over time.
Swelling and a sense of instability are also important clues. Swelling is almost always present after an ACL tear. Once the ACL is torn you also get a sense that your knee is unstable: in other words, that your leg bone could slip abnormally on your thigh bone. This sense of instability is worse going up or down stairs.
Meniscal injuries are gradual, and can lock up on you.
There are tests you can do at home to help figure out what's wrong. In the video Dr. Amy and Ashley demonstrate Lachman's test. With the person with the painful knee sitting down you fixate the thigh bone and attempt to lift the leg bone upward. An intact ACL prevents the bones from moving. Lachman's test if more sensitive at detecting ACL injuries than the MRI (86 % vs. 87% sensitivity); and a negative Lachman test (91% specific) excludes an ACL injury almost as well as MRI as well (93 specific).
There is a test for meniscus injuries as well. McMurray's test is done to detect injuries to the meniscus. The test is done with the patient laying down. The knee if bent, and the examiner flexes then rotates the foot out to check the lateral meniscus, and in to check the medial meniscus. McMurray's test is a great way to exclude a meniscus injury (94% sensitivity); in fact, for the medial meniscus the McMurray test is more specific than the MRI (88% specific), and only one percent worse than the MRI for the lateral meniscus (95% specific). The McMurray test is not as great for detecting an injury to either meniscus (48-79% sensitive); however, the MRI is not enormously better (89% sensitive for the medial, and 78% lateral meniscus).
