(1993) evaluated 104 consecutive patients for the accuracy of the McMurray test for the diagnosis of meniscal tear and also looked at the inter-examiner reliability in performing the test.
This had a bearing on the sensitivity, increasing it to 90% when both tests were positive, however the specificity and diagnostic accuracy were not significantly affected by the addition of a positive McMurray test. (27)
Physical examination (including the Lachman test, Drawer sign, and McMurray test) by an orthopedist or sports medicine-trained physician was 74% to 88% sensitive and 72% to 95% specific for suspected meniscal or ligamentous injuries; MRI added marginal value in referral decisions regarding these conditions.
A Lachman test, Drawer sign, and McMurray test are useful in diagnosing the presence of internal ligamentous injuries without MRI, and an ultrasound can help to detect knee effusion when it is not clinically obvious.
There was an audible click when the flexed left knee was extended while varus pressure was applied (McMurray test
The McMurray test is best for ruling in meniscal pathology.
In a meta-analysis of 13 studies, no physical examination test--including assessment for joint effusion, McMurray test, joint line tenderness, or the Apley compression test--yielded clinically significant positive or negative likelihood ratios for a meniscal tear (Table).
For the McMurray test: LR+ = 1.3 (95% CI, 0.9-1.7) and LR- = 0.8 (95% CI, 0.6-1.1).
As also shown in a recent meta-analysis, (1) no test including examining for joint line tenderness or for joint effusion, the medial-lateral grind test, or McMurray test is of value for determining meniscal tears.
* There is little evidence that the diagnosis of meniscal lesions of the knee can be improved by applying the assessment of joint effusion, the McMurray test, joint line tenderness, or the Apley compression test.
The summary receiver operating characteristic curves of the assessment of joint effusion, the McMurray test, and joint line tenderness indicated little discriminative power for these tests.
Scholten and coworkers looked at the sensitivity, specificity, and other measures of diagnostic accuracy for estimating joint effusion, joint line tenderness, and the McMurray test