Can an md/np say you have a torn miniscus without mri. x-ray was normal.

Sort of: It can certainly be suspected on clinical exam.

Yes but not reliable: Although meniscal tear can be diagnosed by clinical exam, MRI is the mainstay. Clinical exam alone usually miss 30% of cases and in complex knee problems, this is even worse. Besides, clinical exams cannot determine the location, shape, or length of a meniscal tear. These factors are important in treatment decisions.