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Prospective evaluation of the McMurray test
1Division of Orthopaedic Surgery, University of Toronto, Ontario, Canada.
The American Journal of Sports Medicine
|July 1, 1993
Summary
The McMurray test shows limited accuracy for diagnosing meniscal tears. A medial joint line "thud" during the test is specific but not sensitive for medial meniscal tears.
Area of Science:
- Orthopedics
- Sports Medicine
- Diagnostic Accuracy Studies
Background:
- The McMurray test is a common clinical maneuver for diagnosing meniscal tears.
- Assessing the diagnostic accuracy and reliability of physical examination tests is crucial for effective patient management.
Purpose of the Study:
- To evaluate the accuracy and interexaminer reliability of the McMurray test compared to arthroscopic findings for meniscal tear diagnosis.
Main Methods:
- Prospective study involving 104 consecutive patients undergoing elective knee arthroscopy.
- Systematic comparison of McMurray test findings with confirmed arthroscopic surgical results.
Main Results:
- A medial joint line "thud" during the McMurray test showed a significant correlation with medial meniscal tears (P = 0.05).
- This specific sign had fair interexaminer reliability (kappa = 0.35), with 16% sensitivity and 98% specificity.
- Positive predictive value for a medial thud was 83%; examiner experience had minimal impact.
Conclusions:
- The McMurray test, particularly the medial "thud" sign, demonstrates high specificity but low sensitivity for diagnosing medial meniscal tears.
- The study supports a continued, albeit limited, role for the McMurray test in the clinical evaluation of suspected meniscal injuries.