Ege Test

For Medical Students

What It Tests

The Ege test is a weight bearing squat performed with the feet deliberately rotated, which loads one meniscus preferentially depending on the direction.

Feet turned outwards loads the medial meniscus. Feet turned inwards loads the lateral.

So the test attempts to do under load what the McMurray test does unloaded: separate the two menisci by the direction of rotation. 4.9.3 covers the unloaded version.

How It Is Performed

Ask the patient to stand with the feet about shoulder width apart and then to turn both feet outwards, conventionally to around forty-five degrees.

Ask them to squat slowly and then to stand up slowly, noting any pain, click or catch and where it occurs.

Repeat with the feet turned inwards.

Compare the two directions and ask which reproduced their pain.

Provide support and do not persist if the patient cannot squat safely, as with the Childress test. 4.9.6 covers it.

What a Positive Means

Medial joint line pain or a click during the externally rotated squat is a positive for the medial meniscus.

Lateral joint line pain or a click during the internally rotated squat is a positive for the lateral meniscus.

A positive in both directions is non-localising and more likely a degenerate or irritable joint.

Anterior pain in either direction is patellofemoral, because a squat loads the patellofemoral joint whichever way the feet point. 4.15.9 covers it.

An inability to perform the test is a finding rather than a negative.

MRCS Level

How It Is Performed

In a viva the expected points are the two foot positions, the slow squat and rise, the site of the symptom, and the comparison between directions.

The candidate should say why the foot rotation changes which meniscus is loaded, which is that tibial rotation shifts the compressive load between the compartments.

Say that the squat is slow in both directions, because a fast squat reduces the time the meniscus is loaded at any given angle.

Say that you would record which direction was positive, because that is the test's whole contribution.

What a Positive Means

The reasoning is that external tibial rotation with compression loads the medial compartment and internal rotation loads the lateral, which is the same logic as the McMurray and Apley tests applied under body weight.

That makes the Ege test a loaded localising test, and localisation is what it adds.

A direction-specific positive is therefore more informative than a general positive on any other test in this chapter.

A positive in both directions removes that advantage and tells you the joint is irritable rather than which compartment is at fault.

How Good It Is

The Ege test is the least studied of the tests in this chapter and its reported performance is correspondingly uncertain.

The honest position is that it shares the group's pattern, more specific than sensitive, and that its particular contribution is compartment localisation under load.

It has the same availability limitation as the Childress test: a patient who cannot squat cannot be tested, which excludes much of the degenerate population.

It is rarely performed in practice, which means most clinicians have little personal calibration for it, and that is a practical limitation separate from its accuracy.

No figures appear, under decision 023.

FRCS Level

How Good It Is

At decision level the Ege test is useful in one situation: a knee with imaging findings in both compartments where the question is which is symptomatic.

That question matters for a partial procedure and for an osteotomy, and the test answers it by load rather than by palpation. 4.20.7 covers partial replacement assessment.

It is also a functional test, so a patient who can squat in both directions without symptoms has demonstrated something useful.

It contributes nothing to repairability or urgency, like the other provocative tests.

Its practical place is as a confirmatory localising test rather than as part of the routine sequence, and saying that is more honest than listing it as standard.

Where It Misleads

The commonest error is treating an unfamiliar test as more informative than a familiar one because it is less often wrong in one's own experience, which is a sampling artefact.

The second is recording a positive without recording the direction, which discards the only thing the test adds.

The third is attributing a positive to the meniscus without asking where the pain was, because the squat loads several structures.

And performing it in a patient who cannot squat safely, which is a fall risk rather than an examination.

Fellowship Level

Where It Misleads

After surgery this test has the same standing as the other weight bearing tests: more useful as a functional measure than as a provocative one. 4.9.4 and 4.9.6 reach the same conclusion.

Its localising property retains some value in the knee that has had one compartment operated on and now has symptoms, because a positive in the untouched direction points away from the operated compartment.

That is a narrow use and it is the only one this page claims.

After a root repair or a transplant, deep flexion is restricted and the test is a protocol decision rather than a routine. 4.20.3 covers root repair.

At this level the honest summary of the whole provocative group is that they were designed to detect a tear, imaging now detects tears better, and what the examination contributes is attribution and function. These tests were not designed for that and are used for it anyway.

No figure here supports that summary, under decision 023.