Dawaa Reference

Clinical reference

Meniscal Tear

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources4 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 against5 documents
  • 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)

Verified date2026-08

Presentation reference

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

SourceStatPearls "Knee Meniscal Tears" - disease-level clinical article

Presentation findings are traced to the source above.

1

PARACETAMOL

1st line

Strength500 mg

Formoral.solid

Adult dose and duration

1 g 3 or 4 times daily (max. 4 g daily) for knee pain x 1-2 weeks PRN

Paediatric dose

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.)

Dose by weight
3kg30-45 mg/dose
4kg40-60 mg/dose
5kg50-75 mg/dose
6kg60-90 mg/dose
7kg70-105 mg/dose
8kg80-120 mg/dose
9kg90-135 mg/dose
10kg100-150 mg/dose
11kg110-165 mg/dose
12kg120-180 mg/dose
13kg130-195 mg/dose
14kg140-210 mg/dose
15kg150-225 mg/dose
16kg160-240 mg/dose
17kg170-255 mg/dose
18kg180-270 mg/dose
19kg190-285 mg/dose
20kg200-300 mg/dose
21kg210-315 mg/dose
22kg220-330 mg/dose
23kg230-345 mg/dose
24kg240-360 mg/dose
25kg250-375 mg/dose
26kg260-390 mg/dose
27kg270-405 mg/dose
28kg280-420 mg/dose
29kg290-435 mg/dose
30kg300-450 mg/dose
31kg310-465 mg/dose
32kg320-480 mg/dose
33kg330-495 mg/dose
34kg340-500 mg/dose (upper capped)
35kg350-500 mg/dose (upper capped)
36kg360-500 mg/dose (upper capped)
37kg370-500 mg/dose (upper capped)
38kg380-500 mg/dose (upper capped)
39kg390-500 mg/dose (upper capped)
40kg400-500 mg/dose (upper capped)
41kg410-500 mg/dose (upper capped)
42kg420-500 mg/dose (upper capped)
43kg430-500 mg/dose (upper capped)
44kg440-500 mg/dose (upper capped)
45kg450-500 mg/dose (upper capped)
46kg460-500 mg/dose (upper capped)
47kg470-500 mg/dose (upper capped)
48kg480-500 mg/dose (upper capped)
49kg490-500 mg/dose (upper capped)
50kg500 mg/dose (capped)
Dose 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.

Cautions
  • 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.
Egyptian brands
Egyptian brandManufacturerIndicative price
FEBRIMOL 500 MG 20 TAB.PHARCO3.50 EGP (0.17/unit)
CETAMOL 500 MG 20 TABS.MEMPHIS8.00 EGP (0.40/unit)
PARACETAMOL-MUP 500MG B.P. 20 TABS.MUP13.00 EGP (0.65/unit)
CETAL 500 MG 20 TABS.EIPICO24.00 EGP (1.20/unit)
ARKADOLOW 500 MG 30 F.C. TABS.UTOPIA42.00 EGP (1.40/unit)
PARAMOL 500MG 20 TAB.MISR38.00 EGP (1.90/unit)
ADOL 500MG 24 CAPLETSJULPHAR32.00 EGP
AUGICETAMIDE 500 MG 20 SACHETSAUG PHARMA50.00 EGP
FEBRIMOL ORAL DROPS 20 ML? strength differs? different route - not oral solidPHARCO4.00 EGP
THERA-LO 3.2G/100ML ORAL SUSP. 100 ML? strength differs? different route - not oral solidPHAROPHARMA5.00 EGP
2

REFERRAL & SAFETY-NETTING (NO DRUG THERAPY)

1st line
Dose 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.

Cautions
  • RED FLAG - Referral criterion: persistent pain, swelling, or mechanical symptoms despite conservative management should be assessed for surgery.
3

METHYLPREDNISOLONE

2nd line

Strength40 mg

Forminjection

Adult dose and duration

20 to 80 mg (0.5 to 2 ml) for a large joint such as the knee - Single intra-articular injection

Paediatric dose

Not recommended in pediatric traumatic meniscal tears.

Dose 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.

Cautions
  • 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.
Egyptian brands
Egyptian brandManufacturerIndicative price
M.P.A 40MG/ML VIALAMOUN8.50 EGP
EPIZOLONE-DEPOT 40MG/ML 1 ML I.M. VIALEIPICO39.00 EGP
4

NAPROXEN

add-on - not a substitute

Strength500 mg

Formoral.solid

Adult dose and duration

250-500 mg twice daily after food for 7-14 days during acute pain flares x 7-14 days

Paediatric dose

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.

Dose 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.

Cautions
  • 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.
Egyptian brands
Egyptian brandManufacturerIndicative price
ORGOPROXEN 500 MG 20 TAB.ORGANOPHARMA > ORGANO16.00 EGP (0.80/unit)
NAPROSYN 500 MG 10 TAB.MISR > F.HOFFMAN LA ROCHE8.05 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.