Which test is best at ruling in a lateral meniscal tear?

• A. Thessaly test at five degrees of flexion
• B. Joint line tenderness
• C. McMurray test
• D. Thessaly test at twenty degrees

Answer: (B)

Focal joint line tenderness over the lateral knee provides the most specific indicator of a lateral meniscal tear. Palpating along the joint line targets the area where the meniscus attaches and transmits load, so tenderness here directly points to meniscal pathology rather than other knee problems. Provocative maneuvers like McMurray or Thessaly can suggest a tear but are more variable and can yield false positives in degenerative or complex knees, making them less reliable for definitively ruling in a tear. When you find localized lateral joint line tenderness, it strengthens the clinical suspicion for a meniscal injury and guides further imaging referral.