McMurray Test | Meniscus Tear

 McMurray Test | Meniscus Tear

What is McMurray Test?

McMurray test is used to evaluate the injury of the lateral and medial meniscus of the knee joint. It was originally developed to diagnose posterior horn lesions of the medial meniscus. This is the most commonly done test for meniscus tear.

McMurray Test was first described by Thomas Porter McMurray, who was a British orthopedic surgeon.

How do you perform a McMurray knee test?

The patient lies in the supine position, and the clinician, standing on the same side as the involved knee, maximally flexes the hip and knee. This is accomplished by grasping the patient’s foot in such a way that the thumb is lateral, the index and middle fingers are medial, and the ring and little fingers hold the medial edge of the foot. The thumb of one hand is placed against the lateral aspect of the patient’s knee.

  1. To test the medial meniscus: the clinician rotates the tibia into external rotation, then slowly extends the knee.
  2. To test the lateral meniscus: the clinician flexes the knee again but now internally rotates the patient’s tibia and then slowly extends the knee.
McMurray Test

What is a positive McMurray Test?

McMurray test is Positive when there is a click (or catch) and pain in the extension of the knee.

Sensitivity & Specificity

A Meta-Analysis study by Ockert 1 to assess the value of the clinical examination in suspected meniscal injuries, the Sensitivity & Specificity of McMurray Test was:

Another Systematic review and meta-analysis by Eric J Hegedus 2 found that the pooled sensitivity and specificity were 70% and 71% for McMurray test.

Notes

Related Anatomy

In plan view the medial and lateral menisci are C-shaped; they are triangular in cross-section, and formed from dense avascular fibrous tissue.

Their extremities (horns) are attached to the upper surface of the tibia on which they lie; the posterior horn of the lateral meniscus has an additional attachment to the femur, whereas both anterior horns are loosely connected.

The concave margin of each meniscus is unattached; the convex margin of the lateral meniscus is anchored to the tibia by coronary ligaments, whereas the corresponding part of the medial meniscus is attached to the joint capsule) and thereby loosely united to both femur and tibia.

During extension of the knee the menisci slide forwards on the tibial plateau and become progressively more compressed, adapting in shape to the altering contours of the particular portions of the femur and tibia between which they come to lie.

Only the peripheral edges of the menisci have an appreciable blood supply, so that meniscal tears that involve the more central portions have a poor potential for healing.

Lateral Meniscus:

Medial Meniscus:

menisci anatomy
Menisci Anatomy

Meniscal Tear

Meniscal Tear
Meniscal Tear

Reference

  1. Ockert B, Haasters F, Polzer H, Grote S, Kessler MA, Mutschler W, Kanz KG. Der verletzte Meniskus: Wie sicher ist die klinische Untersuchung? Eine Metaanalyse [Value of the clinical examination in suspected meniscal injuries. A meta-analysis]. Unfallchirurg. 2010 Apr;113(4):293-9. German. doi: 10.1007/s00113-009-1702-2. PMID: 19960176.
  2. Hegedus EJ, Cook C, Hasselblad V, Goode A, McCrory DC. Physical examination tests for assessing a torn meniscus in the knee: a systematic review with meta-analysis. J Orthop Sports Phys Ther. 2007 Sep;37(9):541-50. doi: 10.2519/jospt.2007.2560. PMID: 17939613.
  3. Konan S, Rayan F, Haddad FS. Do physical diagnostic tests accurately detect meniscal tears? Knee Surg Sports Traumatol Arthrosc. 2009 Jul;17(7):806-11. doi: 10.1007/s00167-009-0803-3. Epub 2009 Apr 28. PMID: 19399477.
  4. Clinical Tests for the Musculoskeletal System 3rd Edition.
  5. Dutton’s Orthopaedic Examination, Evaluation, And Intervention 3rd Edition.
  6. Sarvdeep S. Dhatt, Sharad Prabhakar – Handbook of Clinical Examination in Orthopedics.
  7. Campbel’s Operative Orthopaedics 12th edition Book.
  8. Millers Review of Orthopaedics -7th Edition Book.
  9. Ronald McRae – Clinical Orthopaedic Examination 6th Edition Book
  10. Netter’s Orthopaedic Clinical Examination An Evidence-Based Approach 3rd Edition Book

Share with Friends:

Read Also:


Related Tests

Posterior Sag Sign

Posterior Sag Sign (or Gravity Drawer Test) is used to assess the integrity of the posterior cruciate ligament of…

Patellar Grind Test

Patellar Grind Test (Zohlen Sign or Clarke sign) is used to evaluate patellofemoral Pain Syndrome (chondromalacia patellae).

Apley Distraction Test

Apley Distraction Test is used to evaluate the integrity of the Collateral Ligaments of the knee, this test…

See Also:

Latest from Orthofixar

Distal Radius Fractures

Distal Radius Fractures is the most common fracture encountered by orthopedic trauma surgeons accounting for 17.5% of all…

Kohler’s Disease

Kohler's Disease (or Osteochondrosis of the tarsal navicular) is an avascular necrosis of the navicular bone of the…

Dupuytren Contracture

Dupuytren contracture is a painless, but progressive flexion contracture of the fingers caused by a benign fibroproliferative disorder.

Mortons Neuroma Symptoms and Treatment

Mortons Neuroma is a compressive neuropathy of the interdigital nerve, usually between the third and fourth metatarsals.

Special Tests App

Special Test Application
Special Test Application