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Prospective evaluation of the McMurray test

Division of Orthopaedic Surgery, University of Toronto, Toronto, Ontario, Canada

G. Douglas Bell, MD, FRCS C

Division of Orthopaedic Surgery and Sport Medicine Centre, University of Calgary, Calgary, Alberta

CY Frank, MD, FRCS C

Division of Orthopaedic Surgery and Sport Medicine Centre, University of Calgary, Calgary, Alberta

The accuracy and interexaminer reliability of the Mc Murray test for the diagnosis of meniscal tears were compared with arthroscopic findings in a prospective study of 104 consecutive patients awaiting elective arthroscopy. The only significant McMurray sign found to correlate with meniscal injury was a "thud" elicited on the medial joint line with a medial meniscal tear (P = 0.05) that had a fair interexaminer reliability (kappa = 0.35). The sensitivity of a medial thud was 16%, and the specificity was 98% with a positive predictive value of 83%. Examiner experience had little effect on the accuracy of diagnosis of medial meniscal tears. This study supports the continued but limited emphasis on the McMurray test in the clinical diagnosis of meniscal tears.

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