Eges Test / Weightbearing McMurray Test | Meniscus Lesion

Summary

In this video, the Aegis test, also known as the weight-bearing memory test, is demonstrated to assess meniscus tears in weight-bearing positions. Unlike traditional non-weight-bearing tests, the Aegis test mimics the McMurray test while the patient stands and squats, providing a more realistic assessment of symptoms during functional activities. The test is suitable for patients who can bear weight without significant pain. Sensitivity and specificity values for lateral and medial meniscus tears are discussed, alongside indications for performing the test. The test involves squatting with different leg rotations to provoke symptoms, with a positive result signified by pain or a click at the joint line.

Takeaways

• 😀 The Aegis test (also known as the weight-bearing memory test) is used to evaluate meniscus tears during weight-bearing activities.
• 😀 Unlike other tests performed in non-weight-bearing positions, the Aegis test attempts to replicate the McMurray test while the patient is standing and squatting.
• 😀 The Aegis test is not suitable for patients in the acute phase of injury, as they must be able to bear weight and squat without significant pain or restricted motion.
• 😀 A 2004 study found the Aegis test to have a sensitivity of 64% for lateral meniscus tears and 67% for medial meniscus tears, with a specificity of 90% and 81%, respectively.
• 😀 The study suggested that the Aegis test performed better than the McMurray test and joint line tenderness for diagnosing meniscus tears, though further confirmation is needed.
• 😀 To perform the Aegis test for a medial meniscus tear, the patient squats with both legs in maximal external rotation, increasing knee separation and external rotation during the squat.
• 😀 For lateral meniscus tears, both legs are held in internal rotation during the squat, with the knees moving closer together and becoming internally rotated during the squat.
• 😀 A positive Aegis test occurs when the patient feels pain or hears a click during the squat, indicating a tear at the corresponding joint line.
• 😀 The test is also considered positive if pain is experienced when the patient stands up after completing the squat.
• 😀 Accuracy of the Aegis test is lower in patients with degenerative arthritis or patellofemoral disease, but it is more accurate in ACL-deficient knees and knees with effusion.

Q & A

What is the purpose of the Aegis test, also known as the weight-bearing memory test?

The Aegis test is designed to assess meniscus tears in weight-bearing positions, as most symptoms of a torn meniscus occur during weight-bearing activities. It mimics the McMurray test but in a standing position.

Why is the Aegis test not suitable for patients in the acute stage of injury?

The Aegis test requires the patient to bear weight and squat without pain or range of motion limitations. Acute injuries typically cause significant pain or loss of movement, making it difficult for the patient to perform the test.

What are the sensitivity and specificity of the Aegis test for lateral and medial meniscus tears?

A study by Ixia Doll in 2004 found that the Aegis test has a sensitivity of 64% for lateral meniscus tears and 67% for medial meniscus tears. Its specificity was 90% for lateral and 81% for medial meniscus tears.

How does the Aegis test compare to the McMurray test and joint line tenderness?

The Aegis test performed better than the McMurray test and joint line tenderness in detecting meniscus tears, according to the 2004 study. However, further research is needed to confirm these findings.

What is the clinical value of the Aegis test in practice?

The Aegis test is considered to have moderate clinical value in practice, as its effectiveness is not fully confirmed but shows promising results compared to other tests for meniscus tears.

How is the Aegis test performed to detect a medial meniscus tear?

To detect a medial meniscus tear, the patient is asked to squat with both legs in maximal external rotation, then slowly stand up. The distance between the knees increases, and each knee becomes externally rotated as the squat progresses.

How is the Aegis test performed to detect a lateral meniscus tear?

For a lateral meniscus tear, both lower extremities are held in maximum internal rotation while the patient squats and stands up. A full squat may not be possible, so a slightly less than full squat is performed.

What happens during the Aegis test when the patient experiences pain or a click?

If the patient feels pain or hears a click at the joint line during the squat, the test is considered positive. The test is stopped when pain or a click is felt, and it can also be positive if pain occurs when rising from the squat.

At what degree of knee flexion does pain typically occur for different types of meniscal tears?

Pain usually occurs around 90 degrees of knee flexion. Anteriorly located meniscal tears tend to produce pain at an earlier degree of flexion, while tears in the posterior horn cause pain at more flexion.

In which cases was the Aegis test found to be more accurate?

The Aegis test was found to be more accurate in ACL-deficient knees and knees with effusion, as compared to knees with degenerative arthritis or patellofemoral disease.