Physical examination After noting symptoms, a physician can perform clinical tests to determine if the pain is caused by compression and impingement of a torn meniscus. The knee is examined for swelling. In meniscal<unk> s, pressing on the joint line on the affected side typically produces tenderness. The McMurray test involves pressing on the joint line while stressing the meniscus (using flexion–extension movements and varus or valgus stress). Similar tests are the Steinmann test (with the patient sitting) and the Apley grind test (a grinding maneuver while the person lies prone and the knee is bent 90°) and the Thessaly test (flexing the affected knee to 20 degrees, pivoting on the knee to see if the pain is reproduced). Bending the knee (into hyperflexion if tolerable), and especially squatting, is typically a painful maneuver if the meniscus is torn. The range of motion of the joint is often restricted. Cooper's sign is present in over 92% of<unk> s. It is a subjective symptom of pain in the affected knee when turning over in bed at night. Osteoarthritic pain is present with weightbearing, but the meniscal<unk>  causes pain with a twisting motion of the knee as the meniscal fragment gets pinched, and the capsular attachment gets stretched causing the complaint of pain. Radiology Bucket-handle<unk>  of the lateral meniscus (red). Medial meniscus intact (green). MRI, coronal T2 *-weighted GRE sequence. X-ray images (normally during weightbearing) can be obtained to rule out other conditions or to see if the patient also has osteoarthritis. The menisci themselves cannot be visualised with plain radiographs. If the diagnosis is not clear from the history and examination, the menisci can be imaged with magnetic resonance imaging (an MRI scan). This technique has replaced previous arthrography, which involved injecting contrast medium into the joint space. In straightforward cases, knee arthroscopy allows quick diagnosis and simultaneous treatment. Recent clinical data shows that MRI and clinical testing are comparable in sensitivity and specificity when looking for a meniscal<unk> . Classification Types of<unk> s A meniscal<unk>  can be classified in various ways, such as by anatomic location or by proximity to blood supply. Various<unk>  patterns and configurations have been described. These include: * Radial<unk> s * Flap or parrot-beak<unk> s * Peripheral, longitudinal<unk> s * Bucket-handle<unk> s * Horizontal cleavage<unk> s * Complex, degenerative<unk> s These<unk> s can then be further classified by their proximity to the meniscus blood supply, namely whether they are located in the “red-red,” “red-white,” or “white-white” zones. The functional importance of these classifications, however, is to ultimately determine whether a meniscus is repairable. The repairability of a meniscus depends on a number of factors. These include: * Age/strength * Activity level *<unk>  pattern * Chronicity of the<unk>  * Associated injuries (anterior cruciate ligament injury) * Healing potential
Meniscus tear
Meniscal cyst
Tenonitis
Superior canal dehiscence syndrome
Penile fracture
Discoid meniscus
Infrapatellar fat pad syndrome
Pneumatocele