The data generated by this study suggest that the Thessaly Test is no better at diagnosing meniscal tears than other established physical tests. We found that neither the Thessaly Test alone or in combination with other physical tests could be reliably used by primary care clinicians as an alternative, or surrogate, for MRI scanning to diagnose meniscal tears in the knee.

We have also found that MRI diagnosis of meniscal tears in comparison with arthroscopic diagnosis was less accurate than is commonly reported in the literature. This was particularly true when MRI is used indiscriminately rather than in targeted populations of patients with specific ‘suspected’ knee pathologies. Further well-defined studies are required to determine the true accuracy of MRI for the diagnosis of meniscal tears.

The findings of this study have implications for primary care clinicians who may wish to consider referral of patients with significant knee pain and injuries to a specialist clinician for assessment and treatment rather than automatic referral for MRI of the knee. This approach is likely to maximise the benefit from MRI and minimise the cost of unnecessary or inappropriate imaging.