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.[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 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 in order to identify a valgus deformity. 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 stabilized in a fully flexed position 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.

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.[2] 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.[3]

The McMurray test is named after Thomas Porter McMurray,[4] a British orthopedic surgeon from the late nineteenth and early twentieth century who was the first to describe this test.

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References[edit]

  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.  edit
  2. ^ 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. 
  3. ^ Jackson JL, O’Malley PG, Kroenke K. Evaluation of acute knee pain in primary care. Ann Intern Med. 2003;139:575-88. PMID 14530229
  4. ^ McMurray TP. The semilunar cartilages. Br J Surg 1942; 29:407-14.

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