American Board of Internal Medicine (ABIM) Certification Practice Exam

Positive symptoms following the Thessaly maneuver should always be first assessed on which leg?

1. Affected leg

2. Uninvolved leg

3. Both legs simultaneously

4. Dominant leg

The correct answer is: Uninvolved leg

The Thessaly maneuver is a clinical test used primarily to assess for meniscal tears in the knee. When performing this maneuver, it is critical to first assess the uninvolved leg to establish a baseline of normal knee function and sensation. This approach allows the examiner to compare the findings from the affected leg against the uninvolved leg, making any positive symptoms more meaningful. By evaluating the uninvolved leg first, the clinician can better understand the patient's normal range of motion, stability, and possible discomfort levels, which can be crucial for accurate diagnosis. Comparisons made after this initial assessment can reveal any deviations or abnormalities that are specifically present in the affected leg, thus refining the diagnostic process. Furthermore, assessing the uninvolved leg minimizes the risk of inadvertently introducing pain or discomfort that may affect the patient's response during the test of the affected leg. Understanding the normal response is integral to distinguishing pathological findings, thereby leading to a more accurate clinical outcome.