Steinman Test

Original Editor Aarti Sareen

Top Contributors - Aarti Sareen, Evan Thomas and Wanda van Niekerk

Introduction

Steinman test is done to diagnose meniscal pathology at the knee joint.The test is divided into 2 parts i.e Steinman part 1 and Steinman part 2 or Steinman's tenderness displacement test. This test is useful to distinguish meniscal pathology from injury to the ligament or osteophytes[1].

Procedure

Steinman part 1


  1. The patient is sitting on the edge of the table, with the knee hanging over at 90 degrees of flexion, Or the patient is lying on the bed supine with the examiner holding the knee at 90 degrees of flexion.
  2. The tibia is rotated laterally then medially.
  3. The test is positive if lateral pain is elicited on medial rotation and medial pain is elicited on lateral rotation.
  4. The test is repeated in various degrees of knee flexion.


Steinman part 2 or Steinman tenderness displacement test:


This test is specifically to differentiate meniscal pathology from injury as the tenderness do not move in case of pathology while flexion and extension.

  1. Joint line tenderness is elicited.
  2. The knee is flexed and joint line is palpated. A positive test is indicated if the tenderness moves posteriorly with increasing flexion.
  3. The knee is extended and joint line palpated again. A positive test is indicated if the tenderness moves anteriorly when the knee is extended.
  4. The test is repeated in various degrees of flexion and extension.

Reliability of the test

The reliability of this test along with other meniscal test is r= 0.88[2]

Specificity (with other meniscal tests)

Medial Meniscus 76%

Latera Meniscus 98%

Overall               87%[3]

Sensitivity (with other meniscal tests)


Medial meniscus 98%

Lateral meniscus 92%

Overall               96.5%[3]

References

  1. Magee DJ.Orthopedic Physical Assessment.5th edition.Elsevier publication.
  2. Rejeski WJ, Ettinger WH, Schumaker S et al: Assessing performance-related disability in patients with knee osteoarthritis, Osteoarthritis Cartilage 3:157-167, 1995.
  3. 3.0 3.1 Muellner T, Weinstabl R, Schabus R et al: The diagnosis of meniscal tears in athletes: a comparison of clinical and magnetic resonance imaging investigations, Am J Sports Med 25(1):7-12, 1997.