Last reviewed:September 2019
Last updated:March  2018



History and exam

Key diagnostic factors

  • presence of risk factors
  • knee swelling
  • sensation of knee instability or buckling/catching
  • knee pain
  • tenderness at joint line and joint line crepitation
  • positive McMurray's test
  • positive Apley's test
  • positive hyperextension test

Other diagnostic factors

  • popliteal (Baker's) cyst in chronic cases
  • limited range of motion

Risk factors

  • acute trauma (twisting injury)
  • knee joint arthritis
  • knee instability
  • hx of anterior cruciate ligament injury
  • malalignment of the knee joint
  • rough or uneven playing surface
  • poor ground/weather conditions
  • construction work and manual labour jobs
  • discoid meniscus

Diagnostic investigations

1st investigations to order

  • MRI scan
  • plain film radiographs: AP x-ray, lateral knee x-ray, 45° PA flexion, and skyline views
Full details

Treatment algorithm


Orthopedic Surgeon

Department of Sports Orthopedics

Toshiba Hospital Tokyo




HT declares that he has no competing interests.

Dr Hideki Takeda would like to gratefully acknowledge Dr Lars Engebretsen and Dr Kevin R. Stone, previous contributors to this monograph. LE declares that he has no competing interests. KRS is an author of several references cited in this monograph.

Peer reviewersVIEW ALL

Co-Director of Orthopedic Sports and Shoulder Service

Department of Orthopedic Surgery

Naval Medical Center San Diego

San Diego



DS declares that he has no competing interests.

Orthopedic Surgeon

Department of Orthopedic Surgery

Seoul Veterans Hospital


South Korea


JRY declares that she has no competing interests.

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