Execution
- 1Position the patient sitting or supine with the knee flexed enough to expose the joint line.
- 2Palpate the medial joint line from anterior to posterior.
- 3Palpate the lateral joint line from anterior to posterior.
- 4Ask whether tenderness matches the patient's familiar pain.
- 5Compare local tenderness with ligament, tendon, and bony landmarks.
Positive outcome
Focal tenderness at the medial or lateral tibiofemoral joint line is positive. The finding supports meniscal involvement only when ligament and other periarticular sources are excluded. Diffuse tenderness is less specific.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Hegedus et al. (2007) | systematic review | 63 | 77 | 2.74 | 0.48 |
| Smith et al. (2015) | systematic review and meta-analysis | 83 | 83 | 4.88 | 0.20 |
CommentJoint line tenderness is common and easy to perform but can be positive with ligament, capsule, synovial, or osteoarthritic pain. Magee notes that only about half of meniscus injuries may show joint line pain or tenderness, especially with ACL tears. Use it as a sensitive component, not proof of a tear.
Moderate Clinical Value