American Board of Internal Medicine (ABIM) Certification Practice Exam

A positive medial-lateral grind maneuver indicates what?

1. Patellar dislocation

2. Meniscal injury

3. Iliotibial band syndrome

4. Hip pathology

The correct answer is: Meniscal injury

A positive medial-lateral grind maneuver is indicative of meniscal injury. This clinical examination technique involves applying pressure along the joint line while moving the knee into flexion and extension. If there is a meniscal tear, this maneuver can reproduce pain or a sense of mechanical catching or grinding, which are common symptoms associated with meniscal injuries. The history of knee pain and activities, particularly those involving twisting motions, combined with positive findings from the grind maneuver, strongly suggest the presence of a meniscal tear. This is because the meniscus acts as a cushion and stabilizer in the knee joint, and tears can lead to significant dysfunction and pain. In contrast, while patellar dislocation, iliotibial band syndrome, and hip pathology may produce knee symptoms, they are not specifically indicated by a positive medial-lateral grind test. Patellar dislocation typically presents with knee instability or the sensation of the knee giving way, iliotibial band syndrome results in lateral knee pain often aggravated by running or repetitive movement, and hip pathology usually presents as hip pain or referred knee pain rather than the mechanical findings noted with a meniscal injury. Therefore, the presence of a positive medial-lateral grind maneuver directly correlates with a meniscal injury diagnosis.