What is the McMurray Test?
The McMurray Test is commonly used in orthopedic examinations to help diagnose damage/tears to the meniscus of the knee. This is another of the most well known and most used special tests in orthopedics. The test is named after Thomas Porter McMurray.
Involved Structures
- Medial meniscus and lateral meniscus of the knee
Diagram by BruceBlaus – Own work, CC BY-SA 4.0, Link
Starting Position
The test is performed with the patient in a relaxed supine position. The knee to be tested should be fully flexed. The examiner holds the sole of the foot with one hand and palpates the medial or lateral aspect of the tibio-fibular joint. This test is used to determine damage to either the lateral or medial meniscus. The examiner palpates the side of the joint being tested. When testing the medial meniscus the tibia starts the manoeuvre in internal rotation. When testing the lateral meniscus the tibia starts the manoeuvre in external rotation.
Test Movement
To test the medial meniscus, the examiner palpates the postero-medial aspect of the knee while extending the knee and externally rotating the tibia. A valgus stress is also applied. To test the lateral meniscus, the examiner palpates the postero-lateral joint line while extending the knee and internally rotating the tibia. A varus stress is also applied.
Positive Test
If pain is felt by the subject or if a ‘click’ is felt by the subject or examiner, the test is considered positive. The test is considered especially positive if there is palpable tenderness along the joint line.
Accuracy of Test
The McMurray Test, in its classic form, is considered to be somewhat accurate while a number of modifications to the test have been developed that have increased its accuracy. It is quite specific to the meniscus but has a slightly lower sensitivity.
- Sensitivity: 79.7%
- Specificity: 78.5%
- Positive Likelihood Ratio: 3.7
- Negative Likelihood Ratio: 0.2
References:
Video Demonstration
video source: reesmd101
What is the Meniscus of the Knee?
The knee actually has two ‘menisci’; the lateral meniscus and the medial meniscus. They are each crescent-shaped and made of cartilage. They are located inside the knee joint itself. The lateral and medial meniscus serves to protect the knee joint by acting as cushions. They help absorb forces in the knee as well as improve the ‘fit’ of the joint. The menisci occupy some of the space between the two bones that make up the knee; the tibia (the lower, ‘shin’ part of the leg) and the femur (the upper ‘thigh’ part of the leg.
>> Return to the list of Common Tests in Orthopaedic Examination of the Knee
Other orthopedic tests for damage to the meniscus of the knee:
- Thessaly Test
- Bounce Home Test
- Apley’s Compression/Grinding Test
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