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TAPPING TEST IN PATIENTS WITH PAINFUL BONE MARROW EDEMA OF THE KNEE



Abstract

Introduction: Although bone marrow edema (BME) of the knee is a common phenomenon, physical tests to diagnose this condition have not been investigated thus far. We hypothesized that a mallet test would be useful as a diagnostic aid as well as a screening tool.

Methods: Seventy patients (36 women, 34 men) were investigated in this blinded controlled study. Group 1 consisted of patients with painful BME in the knee and group 2 of patients with a painful knee without BME. Pain provoked by a reflex mallet was assessed for each quadrant on a visual analog scale (VAS).

Results: The VAS score was 3.7 (±2.1 cm) for quadrants affected by BME (group 1), 1.59 (±1.44) in non-affected quadrants of the knee affected by BME (group 1) and, 0.85 (±0.85) in painful knees without BME (group 2). Pain on the tapping test was significantly correlated with the presence of BME in the affected knee (p< 0.0001) as well as the affected quadrant (p< 0.0001 for the medial femoral condyle and the medial femoral plateau).

Conclusion: The tapping test is a good screening instrument to diagnose BME in the knee.

The abstracts were prepared by Lynne C. Jones, PhD. and Michael A. Mont, MD. Correspondence should be addressed to Lynne C. Jones, PhD., at Suite 201 Good Samaritan Hospital POB, Loch Raven Blvd., Baltimore, MD 21239 USA. Email: ljones3@jhmi.edu