The MCL apprehension sign: A novel test for MCL instability

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Diagnostic Imaging

Background:

• Medial collateral ligament (MCL) injuries are common in sports, often requiring accurate diagnosis for appropriate management.
• Clinical assessment for MCL laxity can be challenging, with potential for missed injuries.

Purpose of the Study:

• To introduce and evaluate a novel clinical sign, the apprehension sign, for diagnosing clinically relevant MCL injuries.
• To assess the utility of the apprehension sign in guiding treatment decisions for MCL injuries.

Main Methods:

• A prospective study involving 30 patients with suspected MCL injury.
• Comparison of the apprehension sign against standard laxity tests and MRI findings.
• Evaluation of sensitivity, specificity, and predictive values of the apprehension sign.

Main Results:

• The apprehension sign demonstrated high sensitivity (85.7%) and specificity (88.8%) for MCL laxity.
• A positive apprehension sign significantly increased the probability of MCL laxity to 94.7%.
• The sign correlated well with MRI-confirmed MCL injuries.

Conclusions:

• The apprehension sign is a reliable and reproducible clinical finding suggestive of MCL injury.
• Its use can aid in determining the need for active treatment, bracing duration, and surgical intervention.
• The apprehension sign serves as a valuable adjunct to standard diagnostic work-ups for MCL injuries.