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McMurrays Test

From Physiopedia

Original Editor - Rachael Lowe

Top Contributors -

Rachael Lowe and Tyler Shultz  

Contents

Purpose

McMurray's test is used to determine the presence of a meniscal tear within the knee. 

Technique

With the patient supine the examiner holds the knee and palpates the joint line with one hand, thumb on one side and fingers on the other, whilst the other hand holds the sole of the foot and acts to support the limb and provide the required movement through range. The examiner then applies a valgus stress to the knee whilst the other hand rotates the leg externally and extends the knee.  Pain and/or an audible click while preforming this maneuver can indicate a torn medial meniscus.   To examine the lateral meniscus the examiner repeats this process from full flexion but applies a varus stress to the knee and medial rotation to the tibia prior to extending the knee once again.


[1]
BJSM Videos[2]

Evidence

Studies of specificity and sensitivity have demonstrated varied values as a result of poor methodological quality[3]  A recent meta-analysis reports sensitivity and specificity to be 70% and 71%.[4]The test has therefore often been reported to be of limited value in current clinical practice.  However if positive findings are grouped with positive findings from other tests, such as joint line tenderness and Apley's test, the test may be more valid.  There are several different reported methods of performing McMurrays Test, Reiders method may be the most accurate[5]

References

  1. online video, http://www.youtube.com/watch?v=IwBW-X4n1fU, last accessed 1/9/08
  2. BJSM Videos, http://www.youtube.com/watch?v=fkt1TOn1UfI, last accessed 1/9/08
  3. Meserve BB, Cleland JA, Boucher TR. (2008) A meta-analysis examining clinical test utilities for assessing meniscal injury. Clinical Rehabilitation, 22(2), 143-61.
  4. Hegedus EJ, Cook C, Hasselblad V, Goode A, McCrory DC. (2007)Physical examination tests for assessing a torn meniscus in the knee: a systematic review with meta-analysis. Journal of Orthopaedic and Sports Physical Therapy, 37(9), 541-50
  5. H Nalwad; M Agarwal; B N Muddu; M Smith; and Mr. J K Borill (2006). McMurrays test revisited: Evaluation of various methods of performing McMurrays test, Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue SUPP_II, 320.

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