Meniscal injuries are very common. The McMurray’s Test is a
rotational maneuver of the knee that is frequently used to aid in the diagnosis
of meniscal tears. With a meniscal tear, the patient usually complains of knee
pain localized to the lateral or medial side of the knee joint. The patient
will have locking, clicking, pain, or effusion.
During the physical examination, joint line tenderness is
the most sensitive finding. Swelling of the knee and a possible extension lag
(locked knee) is also a common finding. Pain at a higher level is usually
associated with the medial collateral ligament. Pain at a lower level is
usually associated with the pes anserine bursa.
What is the McMurrays test?
The McMurray’s test is a knee examination test that provokes
pain or a painful click as the knee is brought from flexion to extension with
either internal or external rotation. The McMurray’s test uses the tibia to
trap the meniscus between the femoral condyles of the femur and the tibia. When
performing the test, the patient should be lying supine with the knee
hyperflexed. The examiner then grasps 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. The knee is then
extended in order to test the lateral meniscus. A positive test is indicated by
pain, clicking or popping within the joint and may signal a tear of either the
medial or lateral meniscus when the knee is brought from flexion to extension.
How reliable is the McMurray’s test?
There are mixed reviews for the validity of this test. An
MRI is a very sensitive exam and makes the diagnosis easier, while excluding
other associated injuries.
