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Accuracy of McMurray and Joint Line Tenderness Tests in the Diagnosis of Chronic Meniscal Tears: An Ad Hoc Receiver Operator Characteristic Analysis Approach.麦克马瑞试验和关节线压痛试验在诊断慢性半月板撕裂中的准确性：一种临时受试者工作特征分析方法
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1
A new weight-bearing meniscal test and a comparison with McMurray's test and joint line tenderness.一种新的负重半月板试验及其与麦克马瑞试验和关节线压痛的比较。
Arthroscopy. 2004 Nov;20(9):951-8. doi: 10.1016/j.arthro.2004.08.020.
2
The value of clinical examination versus magnetic resonance imaging in the diagnosis of meniscal tears and anterior cruciate ligament rupture.临床检查与磁共振成像在诊断半月板撕裂和前交叉韧带断裂中的价值。
Arthroscopy. 2004 Sep;20(7):696-700. doi: 10.1016/j.arthro.2004.06.008.
3
The accuracy of joint line tenderness by physical examination in the diagnosis of meniscal tears.体格检查中关节线压痛对半月板撕裂诊断的准确性。
Arthroscopy. 2003 Oct;19(8):850-4. doi: 10.1016/s0749-8063(03)00736-9.
4
[The accuracy of the clinical diagnosis of meniscal tears with or without associated anterior cruciate ligament tears].[伴有或不伴有前交叉韧带撕裂的半月板撕裂临床诊断的准确性]
Acta Orthop Traumatol Turc. 2003;37(3):193-8.
5
Medial meniscectomy in patients over the age of fifty: a six year follow-up study.五十岁以上患者的内侧半月板切除术：一项六年随访研究。
Swiss Surg. 2002;8(3):113-9. doi: 10.1024/1023-9332.8.3.113.
6
MR imaging of the postoperative meniscus of the knee.膝关节术后半月板的磁共振成像
Semin Musculoskelet Radiol. 2002 Mar;6(1):35-45. doi: 10.1055/s-2002-23162.
7
The rational clinical examination. Does this patient have a torn meniscus or ligament of the knee? Value of the physical examination.合理的临床检查。该患者是否存在膝关节半月板或韧带撕裂？体格检查的价值。
JAMA. 2001 Oct 3;286(13):1610-20. doi: 10.1001/jama.286.13.1610.
8
The impact of magnetic resonance imaging of the knee on surgical decision making.膝关节磁共振成像对手术决策的影响。
Arthroscopy. 1996 Oct;12(5):550-5. doi: 10.1016/s0749-8063(96)90193-0.
9
A comparison of accuracy between clinical examination and magnetic resonance imaging in the diagnosis of meniscal and anterior cruciate ligament tears.临床检查与磁共振成像在诊断半月板和前交叉韧带撕裂中的准确性比较。
Arthroscopy. 1996 Aug;12(4):398-405. doi: 10.1016/s0749-8063(96)90032-8.
10
Anterior knee pain--a symptom not a diagnosis.膝前疼痛——一种症状而非诊断结果。
Bull Rheum Dis. 1993 Apr;42(2):5-7.

最大后关节线压痛对半月板病变诊断的阳性预测值：一项初步研究。

Positive predictive value of maximal posterior joint-line tenderness in diagnosing meniscal pathology: a pilot study.

作者信息

Wadey Veronica M R, Mohtadi Nicholas G H, Bray Robert C, Frank Cyril B

机构信息

Department of Surgery, Division of Orthopaedic Surgery, Holland Orthopaedic and Arthritic Centre, Toronto, Ont., Canada.

出版信息

Can J Surg. 2007 Apr;50(2):96-100.

PMID:17550711
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2384263/
Abstract

OBJECTIVE

The purpose of this prospective study was to determine the positive predictive value (PPV) of the point of maximal posterior joint line tenderness (JLT), as a clinical sign, to diagnose underlying meniscal tears.

METHODS

We conducted a prospective study of patients requiring arthroscopic surgery, who consecutively presented to the University of Calgary's Sport Medicine Centre. The femurotibial joint line was palpated for the point of maximal tenderness. We recorded the data on the arthroscopy report. A second examiner (orthopedic sport medicine surgical fellow or sport medicine physician) performed the same protocol. An arthroscopist documented the site of pathology as detected by arthroscopy.

RESULTS

We found a PPV of 60.0% and a negative predictive value of 62.5%, suggesting that maximal posterior JLT may be predictive of meniscal pathology. The sensitivity and specificity were 84.6% and 31.2%, respectively (p = 0.155), with Fisher's exact test. The kappa score assessed interobserver reliability and was good at 0.48. Patients with maximal posterior JLT but no meniscal pathology did have other confounding pathology and patients with no maximal posterior JLT who had meniscal pathology usually had confounding knee pathology.

CONCLUSIONS

We found a PPV of 60.0% of maximal posterior JLT and meniscal pathology located at the same anatomical site on arthroscopic examination.

摘要

目的

本前瞻性研究的目的是确定最大后关节线压痛（JLT）这一临床体征诊断潜在半月板撕裂的阳性预测值（PPV）。

方法

我们对需要进行关节镜手术的患者进行了一项前瞻性研究，这些患者连续就诊于卡尔加里大学运动医学中心。触诊股胫关节线以确定最大压痛点。我们在关节镜检查报告中记录数据。另一位检查者（骨科运动医学外科住院医师或运动医学医生）执行相同的方案。关节镜医师记录关节镜检查发现的病理部位。

结果

我们发现PPV为60.0%，阴性预测值为62.5%，这表明最大后JLT可能预测半月板病变。经Fisher精确检验，敏感性和特异性分别为84.6%和31.2%（p = 0.155）。kappa评分评估了观察者间的可靠性，为良好的0.48。有最大后JLT但无半月板病变的患者确实有其他混杂病变，而无最大后JLT但有半月板病变的患者通常有混杂的膝关节病变。

结论

我们发现最大后JLT的PPV为60.0%，且关节镜检查时半月板病变位于相同的解剖部位。