What does a positive Appley's Test with pain during compression suggest?

A positive Appley's Test with pain during compression primarily indicates meniscus involvement. This test is specifically designed to assess the integrity of the meniscus in the knee. During the maneuver, the patient is placed in a prone position, and the examiner applies a downward force on the heel while simultaneously rotating the tibia. If the meniscus is injured or torn, compression of the affected meniscus during this test will reproduce pain, confirming the presence of meniscal pathology.

While ligament involvement can also cause knee pain, it is typically assessed through different tests that focus more on stability rather than the specific load and rotation involved in the Appley's Test. Similar reasoning applies to joint capsule swelling and arthrofibrosis; these conditions would not specifically elicit pain in the manner described during a meniscal evaluation. The specificity of the Appley's Test to the meniscus makes it the appropriate interpretation when pain is reported during compression.