Chivers Michael D, Howitt Scott D
Assistant Professor, Clinical Education, Canadian Memorial Chiropractic College, Toronto, Canada.
J Can Chiropr Assoc. 2009 Dec;53(4):319-33.
The objective of this study was to review the physical examination tests available to a practitioner in order to arrive at a clinical diagnosis or suspicion of a meniscal lesion.
The menisci transmit weight bearing forces and increase stability of the knee. The menisci also facilitate nutrition, provide lubrication and shock absorption for the articular cartilage and promote knee proprioception. The combinations of torsional and axial loading appear to be the cause of most meniscal injuries. Diagnosis of acute knee injuries has long been a topic for discussion throughout the orthopedic literature. Many clinical tests and diagnostic studies have been developed to increase the clinician's ability to accurately diagnose these types of disorders of the knee.
The accuracy of all diagnostic tests is thought to be dependant upon the skill of the examiner, and the severity and location of the injury. The multitude of tests described to assess meniscal lesions suggests that none are consistently reliable. However, recent research has focused on a composite score to accurately predict meniscus lesions. The combination of a comprehensive history, multiple physical tests and diagnostic imaging for confirmation is typical for a clinical meniscal lesion diagnosis while the gold standard remains the arthroscopic procedure itself.
本研究的目的是回顾从业者可采用的体格检查测试方法，以便做出半月板损伤的临床诊断或疑似诊断。
半月板传递负重力量并增加膝关节的稳定性。半月板还促进营养供应，为关节软骨提供润滑和减震作用，并促进膝关节本体感觉。扭转和轴向负荷的综合作用似乎是大多数半月板损伤的原因。急性膝关节损伤的诊断长期以来一直是骨科文献中的一个讨论话题。已经开发了许多临床测试和诊断研究，以提高临床医生准确诊断此类膝关节疾病的能力。
所有诊断测试的准确性被认为取决于检查者的技能以及损伤的严重程度和位置。为评估半月板损伤而描述的众多测试表明，没有一种测试始终可靠。然而，最近的研究集中在一个综合评分上，以准确预测半月板损伤。综合病史、多项体格检查和用于确诊的诊断成像相结合，是临床半月板损伤诊断的典型方法，而金标准仍然是关节镜检查本身。
