McMurray Test – Orthopedic Examination of the Knee

The McMurrays test is a common question asked in the orthopaedic practical examinations of MS and DNB.There are many misconceptions as to which force corresponds to which meniscus.Valgus force corresponds to the medial meniscus and varus force to test for lateral meniscus.External rotation for medial meniscus and internal rotation for lateral meniscus.The reason being the said maneuvere causes a suction or vaccum effect to stretch the corresponding meniscus and recreates the pain, thus helping to diagnose which meniscus is torn.

The McMurray Test is a commonly used in orthopedic examinations to test for damage/tears to the the meniscus. This is another of 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

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.

Accuracy of Test

The McMurray Test in it’s classic form is considered to be somewhat accurate while a number of modifications to the test have been developed that have increased it’s accuracy.