McMurray test

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The McMurray test, also known as the McMurray circumduction test is used to evaluate individuals for tears in the meniscus of the knee. 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 ninety degrees while the foot is held by the sole with the other hand. The examiner then places one hand on the lateral side of the knee to stabilize the joint and provide a valgus stress. The other hand rotates the leg externally while extending the knee. If pain or a "click" is felt, this constitutes a "positive McMurray test" for a tear in the medial meniscus. Likewise the medial knee can be stablized and the leg internally 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 lateral meniscus.

The other leg must also be checked for completeness because clicks can arise from normal tendon movement.

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.[1] 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%. The test therefore seems to be of limited value in current clinical practice.

The McMurray test is named after Thomas Porter McMurray, a British orthopedic surgeon from the late nineteenth and early twentieth century.

References

  1. Corea JR, Moussa M, al Othman A (1994). "McMurray's test tested". Knee Surg Sports Traumatol Arthrosc. 2 (2): 70–2. PMID 7584186. 
  • The rational clinical examination. Does this patient have a torn meniscus or ligament of the knee? Value of the physical examination. JAMA. 2001 Oct 3;286(13):1610-20. Review. PMID 11585485.
  • McMurray TP. The semilunar cartilages. Br J Surg 1942; 29:407-14.

See also


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