Ege’s Test
- Fysiobasen
- Sep 15
- 4 min read
Ege’s Test, also known as the weight-bearing McMurray’s test, is a clinical examination used to assess meniscal injuries in the knee joint. The test simulates functional loading during movements such as squatting, combining flexion, extension, and rotation. This makes it particularly useful for identifying meniscal injuries in a weight-bearing scenario, better reflecting sports-related mechanisms than tests performed in a supine position.
Anatomically, the knee joint contains two menisci:
Medial meniscus: C-shaped, larger, less mobile, and attached to the medial collateral ligament.
Lateral meniscus: O-shaped, more mobile, and connected to the popliteus muscle.
Purpose
The purpose of Ege’s Test is to:
Identify injuries to the medial or lateral meniscus
Differentiate between medial and lateral meniscal tears based on rotation
Simulate sports-specific loading conditions where meniscal injuries commonly occur
Clinical Signs
Pain or clicking along the joint line during loading
Often reproduces the patient’s familiar pain
Timing of symptom onset may indicate localization (e.g., anterior horn vs. posterior horn)
Execution
Starting position:
The patient stands with feet 30–40 cm apart and knees extended
For medial meniscus testing, both feet are rotated outward (external rotation)
For lateral meniscus testing, both feet are rotated inward (internal rotation)
Test movement:
Medial meniscus:
The patient performs a squat with maximal external rotation of the knees (genu varus)
The patient then slowly rises back to standing
Lateral meniscus:
The patient performs a squat with maximal internal rotation of the knees (genu valgus)
The patient then slowly rises back to standing
Observation:
The test is positive if the patient experiences pain or hears/feels a click along the joint line during the squat or while standing up
Symptoms often occur around 90° of knee flexion but may appear earlier or later in the movement
Interpretation
Positive test: Pain or clicking in the knee joint during the relevant movement suggests a meniscal injury
Negative test: No pain or clicking during loaded squat movement
Anterior horn lesions often produce symptoms early in flexion, while posterior horn lesions present near maximal flexion.
Clinical Relevance
The test is highly functional since it is performed in a weight-bearing position, stressing the meniscus in ways similar to sports or daily activity
It is well-suited to differentiate between medial and lateral meniscal injuries using the rotational components
The added varus and valgus stresses further load the joint line, increasing the likelihood of provoking clinical signs of meniscal injury
Evidence
Medial meniscus:
Accuracy: 0.71
Sensitivity: 0.67
Specificity: 0.81
Positive likelihood ratio: 3.5
Negative likelihood ratio: 0.4
Lateral meniscus:
Accuracy: 0.84
Sensitivity: 0.64
Specificity: 0.90
Positive likelihood ratio: 5.3
Negative likelihood ratio: 0.5
Ege’s Test has shown greater diagnostic value for lateral meniscal injuries than for medial ones. It is more specific than sensitive, making it useful for confirming meniscal injury when positive, but not sufficient for ruling out injury when negative.
In one study, degenerative medial meniscal tears were missed in 66% of cases (8 of 12), while longitudinal and bucket-handle lesions were detected more effectively with Ege’s Test than with McMurray’s Test.
Limitations
Requires that the patient can bear weight on both legs, making it unsuitable for acute injuries or severe pain
May be difficult to perform correctly without adequate patient instruction and stability
Results may be influenced by balance and pain tolerance
Clinical Use
Should be combined with McMurray’s Test and joint line palpation to increase diagnostic accuracy
A positive Ege’s Test should lead to further evaluation with imaging (MRI) before surgical consideration
Always interpreted in the context of history, activity level, and overall clinical assessment
Summary
Ege’s Test is a functional and dynamic examination for diagnosing meniscal injuries, emphasizing weight-bearing activity. It combines knee flexion, rotation, and varus/valgus stress and has proven to be more specific than sensitive. The test is particularly valuable in sports medicine for evaluating injuries sustained in functional, dynamic situations.
Sources:
Akseki D, Özcan Ö, Boya H, Pınar H. A new weight-bearing meniscal test and a comparison with McMurray’s test and joint line tenderness. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2004 Nov 1;20(9):951-8.
Richmond JC. Knee arthroscopy. McKeon BP, Bono JV, editors. New York: Springer; 2009 Apr 11.
Akseki D, Özcan Ö, Boya H, Pınar H. A new weight-bearing meniscal test and a comparison with McMurray’s test and joint line tenderness. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2004 Nov 1;20(9):951-8.
Hegedus EJ, Cook C, Hasselblad V, Goode A, Mccrory DC. Physical examination tests for assessing a torn meniscus in the knee: a systematic review with meta-analysis. journal of orthopaedic & sports physical therapy. 2007 Sep;37(9):541-50.
Hing W, White S, Reid D, Marshall R. Validity of the McMurray's test and modified versions of the test: a systematic literature review. Journal of Manual & Manipulative Therapy. 2009 Jan 1;17(1):22-35.
Manish Pruthi MS DNB, Ravi K Gupta MS DNB MNAMS FIMSA, Akshay Goel MS. Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India. Current concepts in meniscal injuries.
Bossen D, Jurado M. The Accuracy of Physical Examination Techniques in Diagnosing Meniscus Lesions.
Dan Lorenz, MS, PT, ATC/L, CSCS, KPTA Research Committee Member. Literature Review: CLINICAL TESTS FOR MENISCUS LESIONS.
Hegedus EJ, Cook C, Hasselblad V, Goode A, Mccrory DC. Physical examination tests for assessing a torn meniscus in the knee: a systematic review with meta-analysis. journal of orthopaedic & sports physical therapy. 2007 Sep;37(9):541-50.
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