# Meniscal Tear - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: AAOS Clinical Practice Guideline on Management of Osteoarthritis of the Knee / Meniscal Tears 2021 · Naproxen 500 mg Tablets SmPC section 4.2 (eMC product 2639) · Depo-Medrone with Lidocaine SmPC section 4.2 (eMC product 1081) · Paracetamol 500 mg Tablets SmPC section 4.2 (eMC product 5164) - Verified date: 2026-08 ## Verified against - Paracetamol 500 mg Tablets SmPC section 4.2 (eMC product 5164) - Naproxen 500 mg Tablets SmPC section 4.2 (eMC product 2639) - Depo-Medrone with Lidocaine SmPC section 4.2 (eMC product 1081) - Knee Meniscal Tears - disease-level clinical article (meniscus-tear-clinical.txt) - MSF Essential Drugs 2024 - paracetamol (oral) ## Treatment metadata - Paracetamol — 500 mg — oral.solid - Referral & safety-netting (no drug therapy) - Methylprednisolone — 40 mg — injection - Naproxen — 500 mg — oral.solid ## Complete treatment card ```text MENISCAL TEAR Sources: AAOS Clinical Practice Guideline on Management of Osteoarthritis of the Knee / Meniscal Tears 2021 · Naproxen 500 mg Tablets SmPC section 4.2 (eMC product 2639) · Depo-Medrone with Lidocaine SmPC section 4.2 (eMC product 1081) · Paracetamol 500 mg Tablets SmPC section 4.2 (eMC product 5164) Review status: REVIEWED against Paracetamol 500 mg Tablets SmPC section 4.2 (eMC product 5164), Naproxen 500 mg Tablets SmPC section 4.2 (eMC product 2639), Depo- Medrone with Lidocaine SmPC section 4.2 (eMC product 1081), Knee Meniscal Tears - disease-level clinical article (meniscus-tear- clinical.txt), MSF Essential Drugs 2024 - paracetamol (oral) (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (5) - A popping sensation with immediate knee swelling during a high-impact injury points more toward an ACL tear than an isolated meniscal tear - Swelling that builds up gradually over about a day points more toward an isolated meniscal tear - Low-grade swelling and stiffness can build up over several days with no clear injury event - Knee pain is usually felt along the inner or outer joint line [joint pain · knee pain] - Locking, clicking, catching, or a sense the knee is giving way can occur [joint instability · locking] SIGNS - what you find (6) - Joint-line tenderness with the knee bent to 90 degrees has roughly 83% sensitivity and similar specificity for a meniscal tear - Range of motion can be reduced in flexion or extension, depending on tear type and how much fluid has collected [reduced range of movement] - An abnormal, guarded gait or increased pain on one- or two-legged squatting can occur - The Thessaly test (standing on one leg, squatting to 20 degrees while rotating the knee) runs about 75% sensitive and 87% specific - McMurray's test is roughly 61% sensitive and 84% specific, done by extending the knee from full flexion while holding rotation - Apley's compression test is under 20% sensitive but up to 80% to 90% specific for a tear TESTS (2) - Initial imaging is plain X-rays in several standard views to check for fracture, loose bodies, or arthritis - Against arthroscopy as the reference standard, MRI runs about 93% sensitive for medial tears and 79% for lateral tears IF NOT THIS - what else fits (4) - Other differentials named without a stated discriminator include an ACL or a PCL tear - Also considered are a contusion or iliotibial band syndrome - Knee osteochondritis and a lateral or medial collateral ligament injury are also on the list - Lumbosacral radiculopathy, medial synovial plica irritation, and patellofemoral joint syndromes are also considered Source StatPearls "Knee Meniscal Tears" - disease-level clinical article Status traced to the source above 1. PARACETAMOL [1st line] Adult 1 g 3 or 4 times daily (max. 4 g daily) for knee pain x 1-2 weeks PRN Peds 10-15 mg/kg/dose [child max 500 mg] (Child 1 month and over: 15 mg/kg 3 or 4 times daily (max. 60 mg/kg daily). Child under 1 month: 10 mg/kg 3 or 4 times daily (max. 40 mg/kg daily). Below about 33 kg use a paediatric paracetamol suspension - the 500 mg tablet is not for that weight. Pediatric/adolescent meniscal tears require urgent orthopedic evaluation for repair.) 3kg -> 30-45 mg/dose 4kg -> 40-60 mg/dose 5kg -> 50-75 mg/dose 6kg -> 60-90 mg/dose 7kg -> 70-105 mg/dose 8kg -> 80-120 mg/dose 9kg -> 90-135 mg/dose 10kg -> 100-150 mg/dose 11kg -> 110-165 mg/dose 12kg -> 120-180 mg/dose 13kg -> 130-195 mg/dose 14kg -> 140-210 mg/dose 15kg -> 150-225 mg/dose 16kg -> 160-240 mg/dose 17kg -> 170-255 mg/dose 18kg -> 180-270 mg/dose 19kg -> 190-285 mg/dose 20kg -> 200-300 mg/dose 21kg -> 210-315 mg/dose 22kg -> 220-330 mg/dose 23kg -> 230-345 mg/dose 24kg -> 240-360 mg/dose 25kg -> 250-375 mg/dose 26kg -> 260-390 mg/dose 27kg -> 270-405 mg/dose 28kg -> 280-420 mg/dose 29kg -> 290-435 mg/dose 30kg -> 300-450 mg/dose 31kg -> 310-465 mg/dose 32kg -> 320-480 mg/dose 33kg -> 330-495 mg/dose 34kg -> 340-500 mg/dose (upper capped) 35kg -> 350-500 mg/dose (upper capped) 36kg -> 360-500 mg/dose (upper capped) 37kg -> 370-500 mg/dose (upper capped) 38kg -> 380-500 mg/dose (upper capped) 39kg -> 390-500 mg/dose (upper capped) 40kg -> 400-500 mg/dose (upper capped) 41kg -> 410-500 mg/dose (upper capped) 42kg -> 420-500 mg/dose (upper capped) 43kg -> 430-500 mg/dose (upper capped) 44kg -> 440-500 mg/dose (upper capped) 45kg -> 450-500 mg/dose (upper capped) 46kg -> 460-500 mg/dose (upper capped) 47kg -> 470-500 mg/dose (upper capped) 48kg -> 480-500 mg/dose (upper capped) 49kg -> 490-500 mg/dose (upper capped) 50kg -> 500 mg/dose (capped) Source MSF Essential Drugs 2024 - paracetamol (oral) Why Simple analgesic used as first-line pain control within conservative management (rest, physiotherapy) of a meniscal tear. Caution Conservative initial treatment (PRICE, quadriceps strengthening physiotherapy, analgesia) is first-line for degenerative tears. Locked knee (mechanical extension block from bucket-handle tear) requires urgent orthopedic referral for arthroscopy. Do not exceed 4000 mg daily. 500 mg is the per-dose ceiling used here for a child. 1000 mg is the adult dose and does not belong in a weight calculation - the daily 60 mg/kg limit is the one that binds first in any case. Egypt FEBRIMOL 500 MG 20 TAB. PHARCO 3.50 EGP (0.17/unit) CETAMOL 500 MG 20 TABS. MEMPHIS 8.00 EGP (0.40/unit) PARACETAMOL-MUP 500MG B.P. 20 TABS. MUP 13.00 EGP (0.65/unit) CETAL 500 MG 20 TABS. EIPICO 24.00 EGP (1.20/unit) ARKADOLOW 500 MG 30 F.C. TABS. UTOPIA 42.00 EGP (1.40/unit) PARAMOL 500MG 20 TAB. MISR 38.00 EGP (1.90/unit) ADOL 500MG 24 CAPLETS JULPHAR 32.00 EGP AUGICETAMIDE 500 MG 20 SACHETS AUG PHARMA 50.00 EGP FEBRIMOL ORAL DROPS 20 ML PHARCO 4.00 EGP -> ? strength differs, ? different route - not oral solid THERA-LO 3.2G/100ML ORAL SUSP. 100 ML PHAROPHARMA 5.00 EGP -> ? strength differs, ? different route - not oral solid 2. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Source Knee Meniscal Tears - disease-level clinical article (meniscus-tear-clinical.txt) Why Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen. Caution RED FLAG - Referral criterion: persistent pain, swelling, or mechanical symptoms despite conservative management should be assessed for surgery. 3. METHYLPREDNISOLONE [2nd line] Adult 20 to 80 mg (0.5 to 2 ml) for a large joint such as the knee - Single intra-articular injection Peds Not recommended in pediatric traumatic meniscal tears. Source Depo-Medrone with Lidocaine SmPC section 4.2 (eMC product 1081) Why Provides short-term anti-inflammatory relief in degenerative meniscal tears associated with knee osteoarthritis. Caution Strict aseptic technique required to prevent septic arthritis. Limit frequency to max 3-4 intra-articular injections per year into the knee to avoid articular cartilage degeneration. Contraindicated in systemic infection unless treated; avoid local injection into a previously infected joint. Egypt M.P.A 40MG/ML VIAL AMOUN 8.50 EGP EPIZOLONE-DEPOT 40MG/ML 1 ML I.M. VIAL EIPICO 39.00 EGP 4. NAPROXEN [add-on - not a substitute] Adult 250-500 mg twice daily after food for 7-14 days during acute pain flares x 7-14 days Peds Not recommended under 16 years for this indication - the product label restricts paediatric naproxen to juvenile idiopathic arthritis (10 mg/kg/day in two divided doses, child over 5 years). Use paracetamol or ibuprofen instead. Source Naproxen 500 mg Tablets SmPC section 4.2 (eMC product 2639) Why NSAID added to paracetamol and conservative measures for flares of inflammatory pain, not a replacement for the physiotherapy-led conservative approach that remains first- line for degenerative tears. Caution Take with food; GI co-protection (PPI) advised in elderly or high-risk patients. Contraindicated in severe renal impairment, active GI ulcer, or late pregnancy. The weight fields are empty on purpose. The note already says naproxen is not for under-16s in this indication, but the numbers stayed behind it and the calculator went on drawing a dose for a 10 kg child. A withdrawn drug must not still have a working dose card. Egypt ORGOPROXEN 500 MG 20 TAB. ORGANOPHARMA ... 16.00 EGP (0.80/unit) NAPROSYN 500 MG 10 TAB. MISR > F.HOFF... 8.05 EGP (0.81/unit) NAPROFEN 500MG 10 TAB. EL NILE. 12.00 EGP (1.20/unit) NAPROFEN 500MG 20 TAB. EL NILE. 24.00 EGP (1.20/unit) Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)