Meniscal tear

Last reviewed: 8 Nov 2022
Last updated: 08 Sep 2020



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
More key diagnostic factors

Other diagnostic factors

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

Risk factors

  • acute trauma (twisting injury)
  • knee joint arthritis
  • knee instability
  • history 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
More risk factors

Diagnostic investigations

1st investigations to order

  • MRI scan
  • plain film radiographs: AP x-ray, lateral knee x-ray, 45° PA flexion, and skyline views
More 1st investigations to order

Investigations to consider

  • arthroscopy
More investigations to consider

Treatment algorithm


all patients



Hideki Takeda, MD

Orthopedic Surgeon

Department of Sports Orthopedics

NTT Medical Center 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 topic. LE declares that he has no competing interests. KRS is an author of several references cited in this topic.

Peer reviewers

Daniel Solomon, MD

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.

Jung-Ro Yoon, MD

Orthopedic Surgeon

Department of Orthopedic Surgery

Seoul Veterans Hospital


South Korea


JRY declares that she has no competing interests.

  • Meniscal tear images
  • Differentials

    • Anterior cruciate ligament tear
    • Medial collateral ligament sprain
    • Posterior cruciate ligament sprain
    More Differentials
  • Guidelines

    • Arthroscopic meniscal surgery: a national society treatment guideline and consensus statement
    • National consensus on the definition, investigation, and classification of meniscal lesions of the knee
    More Guidelines
  • Patient leaflets


    More Patient leaflets
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