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The Thessaly test is a clinical diagnostic procedure used to detect meniscal tears in the knee joint. It is performed while standing on one leg.
The Thessaly test is a clinical diagnostic procedure used to detect meniscal tears in the knee joint. It is performed while standing on one leg.
The Thessaly test is a clinical examination technique used by medical professionals to identify meniscal tears in the knee joint. It was first described in 2005 by Karachalios and colleagues and is considered one of the most accurate manual tests for evaluating meniscal lesions. The test mimics the mechanical loading of the knee during everyday activities and aims to reproduce symptoms associated with meniscal damage.
The test is conducted in two variations: at 20 degrees of knee flexion (standard version) and at 5 degrees of knee flexion. The patient stands on the leg being examined and lightly holds the examiner's hands for balance. The patient then rotates the body three times inward and outward while maintaining the slightly bent knee position.
The Thessaly test is considered positive when the patient experiences pain along the medial (inner) or lateral (outer) joint line of the knee during rotation. Additionally, locking sensations or an audible click within the knee joint may indicate a meniscal lesion. The location of pain varies depending on whether the medial or lateral meniscus is affected.
Studies have shown that the Thessaly test at 20 degrees of knee flexion has a sensitivity of approximately 89% for the medial meniscus and approximately 92% for the lateral meniscus. The specificity is reported at around 97% and 96% respectively. This makes it one of the most informative clinical tests for meniscal injuries, although it cannot fully replace imaging diagnostics such as MRI (Magnetic Resonance Imaging).
The Thessaly test is regularly used in orthopedic and sports medicine practice, particularly for patients presenting with knee pain, suspected sports injuries, or degenerative meniscal damage. It is non-invasive, quick to perform, and allows an initial assessment before imaging is obtained. A positive result typically warrants further diagnostic workup with MRI to assess the extent of the injury.
The Thessaly test is not suitable for patients with severe knee pain, balance disorders, or acute injuries, as the single-leg stance and rotational movement may place additional strain on the joint. In elderly patients or those with comorbidities such as osteoarthritis, the diagnostic reliability of the test may also be reduced.
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