McMurray test

The McMurray test, also known as the McMurray circumduction test is used to evaluate individuals for tears in the meniscus of the knee.[1] It is a rotation test for demonstrating torn cartilage of the knee. A tear in the meniscus may cause a pedunculated tag of the meniscus which may become jammed between the joint surfaces.

To perform the test, the knee is held by one hand, which is placed along the joint line, and flexed to complete flexion while the foot is held by the sole of the foot with the other hand. The examiner then places one hand on the medial side of the knee to pull the knee towards varus position,[2] pulling the knee laterally (bow legged). The other hand rotates the leg internally while extending the knee.[3] If pain or a "click" is felt, this constitutes a "positive McMurray test" for a tear in the lateral meniscus.

Likewise, valgus pressure on the lateral knee can be applied in a fully flexed position and the leg at the sole of the foot externally rotated as the leg is extended. A tag, caused by a tear will cause a palpable or even audible click on extension of the knee. A positive test indicates a tear of the medial meniscus.

According to some sources, the sensitivity of the McMurray test for medial meniscus tears is 53% and the specificity is 59%. In a recent study, clinical test results were compared with arthroscopic and/or arthrotomy findings as reference.[4] The clinical test had a sensitivity of 58.5%, a specificity of 93.4%, and the predictive value of a positive result was 82.6%. A more recent study showed a 97% specificity for meniscal tears.[5]

The McMurray test is named after Thomas Porter McMurray,[6] a British orthopedic surgeon from the late nineteenth and early twentieth century who was the first to describe this test.

See also

References

  1. ↑ Solomon, D. H.; Simel, D. L.; Bates, D. W.; Katz, J. N.; Schaffer, J. L. (2001). "The rational clinical examination. Does this patient have a torn meniscus or ligament of the knee? Value of the physical examination". JAMA: the Journal of the American Medical Association. 286 (13): 1610–1620. doi:10.1001/jama.286.13.1610. PMID 11585485.
  2. ↑ http://www.fpnotebook.com/ortho/exam/McmryTst.htm
  3. ↑ Luke, Anthony (2011). "Physical Examination". Sports Medicine. Department of Orthopaedic Surgery, Orthopaedic Trauma Institute of UCSF. Retrieved 1 September 2015.
  4. ↑ Corea JR, Moussa M, al Othman A (1994). "McMurray's test tested". Knee Surg Sports Traumatol Arthrosc. 2 (2): 70–72. doi:10.1007/BF01476474. PMID 7584186.
  5. ↑ Jackson JL, O’Malley PG, Kroenke K. Evaluation of acute knee pain in primary care. Ann Intern Med. 2003;139:575-88. PMID 14530229
  6. ↑ McMurray TP. The semilunar cartilages. Br J Surg 1942; 29:407-14.

External links

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