McMurrays Test: Difference between revisions

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== Purpose<br> ==
== Purpose  ==


McMurray's test is used to determine the presence of a [[Meniscal Lesions|meniscal tear]] within the knee.&nbsp; <br>
McMurray's test is used to determine the presence of a [[Meniscal Lesions|meniscal tear]] within the knee.  


== Technique<br> ==
== 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.&nbsp; Pain and/or an audible click while preforming this maneuver can indicate a torn medial meniscus.&nbsp;&nbsp; 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.<br>  
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.&nbsp; Pain and/or an audible click while performing this maneuver can indicate a torn medial meniscus.&nbsp;&nbsp; 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.<br>  


{{#ev:youtube|lwDFPAyGGgI}}<ref>Physiotutors. McMurray Test⎟Meniscus Damage. Available from: https://www.youtube.com/watch?v=lwDFPAyGGgI </ref>
{{#ev:youtube|lwDFPAyGGgI}}<ref>Physiotutors. McMurray Test⎟Meniscus Damage. Available from: https://www.youtube.com/watch?v=lwDFPAyGGgI </ref>
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== Evidence  ==
== Evidence  ==


Studies of specificity and sensitivity have demonstrated varied values as a result of poor methodological quality<ref>[http://cre.sagepub.com/cgi/content/abstract/22/2/143 Meserve BB, Cleland JA, Boucher TR. (2008) A meta-analysis examining clinical test utilities for assessing meniscal injury. Clinical Rehabilitation, 22(2), 143-61.]</ref>&nbsp; A recent meta-analysis reports sensitivity and specificity to be 70% and 71%.<ref>[http://www.jospt.org/issues/articleID.1307,type.2/article_detail.asp 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]</ref>The test has therefore often been reported to be of limited value in current clinical practice.&nbsp; However if positive findings are grouped with positive findings from other tests, such as joint line tenderness and [[Apley's Test|Apley's test]], the test may be more valid.&nbsp; There are several different reported methods of performing McMurrays Test, Reiders method may be the most accurate<ref>[http://proceedings.jbjs.org.uk/cgi/content/abstract/90-B/SUPP_II/320-e 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.]</ref>
Studies of specificity and sensitivity have demonstrated varied values as a result of poor methodological quality<ref>[http://cre.sagepub.com/cgi/content/abstract/22/2/143 Meserve BB, Cleland JA, Boucher TR. (2008) A meta-analysis examining clinical test utilities for assessing meniscal injury. Clinical Rehabilitation, 22(2), 143-61.]</ref>&nbsp; A recent meta-analysis reports sensitivity and specificity to be 70% and 71%.<ref>[http://www.jospt.org/issues/articleID.1307,type.2/article_detail.asp 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]</ref>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|Apley's test]], the test may be more valid.&nbsp; There are several different reported methods of performing McMurrays Test, Reiders method may be the most accurate<ref>[http://proceedings.jbjs.org.uk/cgi/content/abstract/90-B/SUPP_II/320-e 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.]</ref>  
 
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed])  ==
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== References  ==
== References  ==

Revision as of 08:15, 6 December 2017

Purpose[edit | edit source]

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

Technique[edit | edit source]

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 performing 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]

Evidence[edit | edit source]

Studies of specificity and sensitivity have demonstrated varied values as a result of poor methodological quality[2]  A recent meta-analysis reports sensitivity and specificity to be 70% and 71%.[3]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[4]

References[edit | edit source]