McMurray’s Test for Meniscal Tear

Courtesy: Prof Nabil Ebraheim, University of Toledo, Ohio, USA

Mc Murray’s Test for Meniscal Tear

Commonly used test in orthopaedic examination to test for tear of the meniscus .This test is a rotational maneuver of the knee that is frequently used in the examination of the patient in the diagnosis of meniscal tears. Meniscal tears are very common .When patient sustains an injury of knee and has a meniscal tear, usually the patient complaints of knee pain localized to the medial or lateral side of the knee.The patient also have locking and clicking .Sometimes patient will have an effusion

EXAMINATION
• Joint line tenderness is the most sensitive finding .It can be on the medial side (medial meniscal tear ),or on the lateral side (lateral meniscal tear).
• Minimal swelling of the knee.
• Possible extension lag (locked knee),due to displaced bucket handle tear of the meniscus.
• Pain at higher level than the joint is usually associated with medial collateral ligament tear.pain at the lower level is usually associated with the pes anserine bursitis.

Mc Murray’s test
Knee examination test ,that shows pain or a painful click as the knee is brought from flexion to extension with either internal or external rotation of knee.
Mc Murray’s test uses the tibia to trap the meniscus between the femoral condyles of the femur and tibia.
Patient should be lying supine with knee hyperflexed. The examiner then grasp the patient’s heel with one hand and places the other hand over the knee joint.
To test the medial meniscus, the knee is fully flexed and the examiner then passively externally rotates the tibia and places a valgus force. The knee is then extended in order to test the medial meniscus.
To test the lateral meniscus , the examiner passively internally rotates the tibia and places a varus force and then knee is extended.
A positive test is indicated by pain ,clicking or popping within the knee joint and may signal a tear of either the medial or lateral meniscus when the knee is brought from flexion to extension.

RELIABILITY OF TEST
Other clinical test like MRI is used to confirm the diagnosis of meniscal tear. MRI is sensitive and it identifies associated injury. Mc Murray’s test is valuable in getting approval for performing an MRI.