Akseki Devrim, Ozcan Ozal, Boya Hakan, Pinar Halit
Department of Orthopaedics, Celal Bayar University School of Medicine, Manisa, Turkey.
Arthroscopy. 2004 Nov;20(9):951-8. doi: 10.1016/j.arthro.2004.08.020.
The purpose of this study was to describe a new weight-bearing McMurray's test (Ege's test) and to compare its diagnostic value with McMurray's test and joint line tenderness (JLT). We also aimed to determine if associated lesions had any effect on the diagnostic values of the 3 tests.
Prospective controlled trial, clinical study.
The study group consisted of 150 consecutive patients who had had symptoms related to intra-articular knee pathology, and arthroscopic diagnoses were used as the gold standard.
There were a total of 211 diagnoses on arthroscopy. A meniscus tear was found in 127 of the 150 patients; 90 had medial, 28 had lateral, and 9 had tears of both menisci. There were no statistically significant differences between the 3 tests in detecting a meniscal tear ( P > .05). However, better accuracy, sensitivity, and specificity rates were obtained with Ege's test for medial meniscal lesions (71%, 67%, and 81%, respectively). JLT also gave superior accuracy rates (71%), but the specificity of Ege's test was apparently higher than JLT (81% v 44%). The highest positive predictive value was also obtained with Ege's test (86%), whereas a superior negative predictive value was obtained with JLT (67%) in medial meniscal tears. Lateral meniscal tears were diagnosed more accurately than medial meniscal tears, and Ege's test gave results superior to the others (84%, 64%, 90% for accuracy, sensitivity, and specificity, respectively). Higher positive predictive values were obtained with McMurray's and Ege's tests than with JLT, but similar negative predictive values were achieved in all. A torn anterior cruciate ligament did not decrease the diagnostic values of the 3 tests, whereas the number of associated lesions in the knee negatively affected the diagnostic capabilities of the tests.
Accuracies of traditional clinical meniscus tests may be improved by including Ege's test in the clinical examination.
Level II, diagnostic.
本研究旨在描述一种新的负重麦克马瑞试验（埃格试验），并将其诊断价值与麦克马瑞试验及关节线压痛（JLT）进行比较。我们还旨在确定相关病变是否对这三项试验的诊断价值有任何影响。
前瞻性对照试验，临床研究。
研究组由150例连续的有膝关节内病变相关症状的患者组成，关节镜诊断作为金标准。
关节镜检查共作出211例诊断。150例患者中有127例发现半月板撕裂；90例为内侧半月板撕裂，28例为外侧半月板撕裂，9例为双侧半月板撕裂。三项试验在检测半月板撕裂方面无统计学显著差异（P>.05）。然而，埃格试验对内侧半月板损伤的准确性、敏感性和特异性更高（分别为71%、67%和81%）。JLT的准确率也较高（71%），但埃格试验的特异性明显高于JLT（81%对44%）。埃格试验的阳性预测值也最高（86%），而在诊断内侧半月板撕裂时，JLT的阴性预测值更高（67%）。外侧半月板撕裂的诊断比内侧半月板撕裂更准确，埃格试验的结果优于其他试验（准确率、敏感性和特异性分别为84%、64%、90%）。麦克马瑞试验和埃格试验的阳性预测值高于JLT，但三者的阴性预测值相似。前交叉韧带撕裂并未降低这三项试验的诊断价值，而膝关节相关病变的数量对这些试验的诊断能力有负面影响。
在临床检查中加入埃格试验可提高传统临床半月板试验的准确性。
二级，诊断性。
