Exam

McMurray Test

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McMurray Test, McMurray's Test

  • Indication
  1. Evaluation for Knee Meniscus Injury
  • Efficacy
  1. Test Sensitivity: 26 to 58%
  2. Test Specificity: 59 to 94%
  3. Probability of injury if positive: 66% (Positive Likelihood Ratio 17.3)
  4. Probability of injury if negative: 5% (Negative Likelihood Ratio 0.5)
  5. References
    1. Jackson (2003) Ann Intern Med 139(7): 575-88 [PubMed]
    2. Solomon (2001) JAMA 286:1610-20 [PubMed]
  • Technique
  1. Patient lies supine
    1. Knee flexed to 45 degrees
    2. Hip flexed to 45 degrees
  2. Examiner braces lower leg
    1. One hand holds ankle
    2. Other hand holds knee
  3. Medial meniscus assessment
    1. Assess for pain on palpation
      1. Palpate medial joint line with knee flexed
    2. Assess for "click" suggesting meniscus relocation
      1. Apply valgus stress to flexed knee
      2. Externally rotate leg (toes point outward)
      3. Slowly extend the knee while still in valgus
    3. Images
      1. orthoKneeMcMurrayMedial.jpg
  4. Lateral meniscus
    1. Repeat above with varus stress and internal rotation
    2. Images
      1. orthoKneeMcMurrayLateral.jpg
  1. "Click" heard or palpated on above maneuvers
  2. Joint line tenderness on palpation