Clinical knee examination is focused on looking for evidence of asymmetry when compared with the opposite knee. Evidence of muscle weakness, reduced bulk, knee swelling (effusion) and localised knee tenderness will likely give a probable diagnosis. Examination of the knee alignment and patellar tracking is important. Testing the iliotibial band for sensitivity is essential. Testing for meniscal pain such as the Apley grind test is important.
X-rays are an important part of investigation. They must include Erect, Rosenberg Skyline and lateral views. Frequently x-rays are undertaken lying down. Supine x-rays are of limited value.
MRI is useful for evaluation of meniscal and ligament injury. It will show evidence of bone marrow oedema/bone bruising. Occasionally, it will identify microtrabecular fracture.