The McMurray test assesses the integrity of the menisci, the crescent-shaped pair of shock absorbers in the knee.

Page updated February 2024 by Dr Sheila Strover (Clinical Editor)

mcmurray test
Illustration of a surgeon performing the McMurray test. The premise is that stressing the joint may elicit a 'click' if a meniscus is torn or unstable.

 

 

How is the McMurray test performed?

The patient lies on their back with the knee bent to 90 degrees. The surgeon uses one hand on the knee to apply a valgus force (stressing the knee inwards) while the other hand grasps the patient's foot (sole) and rotates the lower limb externally (outwards). Then the test is repeated and the opposite stresses applied. If a click is felt or heard or the patient experiences pain, the test is considered to be positive.

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What does a positive McMurray test mean?

A positive test will be recorded in the notes, but it is not highly diagnostic of a tear in the meniscus, and more investigations are likely indicated. Conversely, a negative test means that no click or pain was elicited, but it does not necessarily mean that all is well inside the knee.

In terms of other office tests, Ege's test has a better reputation for accuracy. MRI scan is considered the diagnostic investigative method of choice for meniscus tears, but it has a high cost and may pick up false positives.

The whole story needs to be taken into consideration - history of an injury, what disability was experienced after the injury, history of post-injury swelling, feelings of instability - it will all help towards making an evaluation.

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What is the best test for a meniscus tear?

Arthroscopy remains the gold standard for definitive diagnosis, but of course it is an invasive procedure.

  • Quote from peer-reviewed paper:

    "....no clinical assessment or advanced investigations such as MRI diagnose meniscal tears in all patients....The advent of arthroscopy of the knee has revolutionalised the diagnosis and treatment of meniscal tears"

    Citation: Mohan BR, Gosal HS. Reliability of clinical diagnosis in meniscal tears. Int Orthop. 2007 Feb;31(1):57-60. doi: 10.1007/s00264-006-0131-x. Epub 2006 Apr 22. PMID: 16633811; PMCID: PMC2267536.

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What is the relevance of a meniscus tear?

A torn meniscus may cause knee instability, with falls and possible extension of the tear, and even stressing the cruciate ligaments so they tear also. Most knee surgeons would feel it important to try to stabilise the knee by repairing the meniscus where possible.

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Synonyms: 
McMurray's test
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Dr Sheila Strover (Editor)
BSc (Hons), MB BCh, MBA

See biography...

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Other meniscus tests -


Video - a typical story -

Professor Adrian Wilson2012 - Medial meniscus tear - a typical story - by Professor Adrian Wilson (Knee Surgeon) (Knee Surgeon)


Important consensus -