Comparison of the Thesslay Test and McMurray Test: A Systematic Review of Comparative Diagnostic Studies

Alexanders, Jenny; Anderson, A. F.; Henderson, Sarah L.; Clausen, Ulf

doi:10.4172/2573-0312.1000104

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…The idea that a functional weightbearing test will have high specificity is not unique to the hip, as the Thessaly test has been shown to have reasonably high specificity in detecting meniscal tears in the knee. 1,15 To our knowledge, only 1 other weightbearing test has been described for diagnosing hip labral tears, the maximal squat test, which reported limited sensitivity and specificity. 3 Finally, this relatively simple test does not require the presence of a skilled examiner, making it particularly useful in the current state of health care in which telemedicine is becoming increasingly necessary.…”

Section: Discussionmentioning

confidence: 99%

Two Novel Clinical Tests for the Diagnosis of Hip Labral Tears

et al. 2023

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Background: There are few well-studied clinical tests for the diagnosis of hip labral tears. As the differential diagnosis for hip pain is broad, accurate clinical examination is important in guiding advanced imaging and identifying patients who may benefit from surgical management. Purpose: To determine the diagnostic accuracy of 2 novel clinical tests for the diagnosis of hip labral tears. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Clinical examination findings including the Arlington, twist, and flexion-adduction-internal rotation (FADIR)/impingement tests as performed by a fellowship-trained orthopaedic surgeon specializing in hip arthroscopy were obtained from retrospective chart review. The Arlington test ranges the hip from flexion-abduction-external rotation to FADIR while applying subtle internal rotation and external rotation motion. The twist test involves internal rotation and external rotation of the hip while weightbearing. Diagnostic accuracy statistics for each of the tests were calculated using magnetic resonance arthrography as the reference standard. Results: A total of 283 patients were included in the study with a mean age of 40.7 years (range, 13-77 years) and 66.4% were women. The Arlington test was found to have a sensitivity of 0.94 (95% CI, 0.90-0.96), specificity of 0.33 (95% CI, 0.16-0.56), positive predictive value (PPV) of 0.95 (95% CI, 0.92-0.97), and negative predictive value (NPV) of 0.26 (95% CI, 0.13-0.46). The twist test was found to have a sensitivity of 0.68 (95% CI, 0.62-0.73), specificity of 0.72 (95% CI, 0.49-0.88), PPV of 0.97 (95% CI, 0.94-0.99), and NPV of 0.13 (95% CI, 0.08-0.21). The FADIR/impingement test was found to have a sensitivity of 0.43 (95% CI, 0.37-0.49), specificity of 0.56 (95% CI, 0.34-0.75), PPV of 0.93 (95% CI, 0.87-0.97), and NPV of 0.06 (95% CI, 0.03-0.11). The Arlington test was significantly more sensitive than both the twist and FADIR/impingement tests ( P < .05), while the twist test was significantly more specific than the Arlington test ( P < .05). Conclusion: The Arlington test is more sensitive than the traditional FADIR/impingement test, while the twist test is more specific than the FADIR/impingement test in diagnosing hip labral tears in the hands of an experienced orthopaedic surgeon.

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Section: Discussionmentioning

confidence: 99%

Two Novel Clinical Tests for the Diagnosis of Hip Labral Tears

et al. 2023

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“…Of all the meniscal tests available the McMurray test is thought to be the most widely used. This test, first described in 1940, involves the examiner applying a valgus/varus stress and external/internal rotation to the patient's knee during passive knee extension 7 . In a study, the prevalence of medial meniscal tear was found to be 45.16% and the sensitivity, specificity, positive predictive value, negative predictive value and accuracy for McMurray's test for diagnosing medial meniscus tear were 54%, 79%, 68%,67.50% and 67.74% respectively 8 .…”

Section: Introductionmentioning

confidence: 99%

Mcmurray Test for Diagnosis of the Meniscal Tears

Khan,

Raza,

Ovais

et al. 2023

PJMHS

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Aim: Meniscal tears are the most common injury of the knee. Tears of medial meniscus are seen more frequently as compared to lateral meniscus. Most often tears result from sports injuries where there is a twisting motion on the partially flexed, weight-bearing knee. As majority of our population resides in peripheries where access to arthroscopy and imaging modalities is difficult so we need a clinical test for evaluation of medial meniscal tears. And then this technique can be opted in our practice for early diagnosis of meniscal tears in order to take proper management for reducing morbidity of these particular patient, if its diagnostic accuracy comes out to high. Objective: To determine the diagnostic accuracy of McMurray test in diagnosing medial meniscal tears, taking arthroscopy as gold standard. Materials and Methods: This Cross-sectional validation study was carried out in Orthopedic Department of Medical Teaching Institute Lady Reading Hospital Peshawar from July 2021 to June 2023.In this study a total of 149 patients were observed. McMurray test was performed by the a single and same consultant and was looked for medial meniscal tear (present/absent).After this arthroscopy was done in each patient by the consultant orthopedic surgeon who has examined the patient and presence or absence of medial meniscal tear was noted. McMurray test results were compared with arthroscopy result. Results: In this study mean age was 30 years with SD ± 11.35. Eighty five percent patients were male and 15% patients were female. Diagnostic accuracy of MacMurray Test findings taking arthroscopy as gold standard was analyzed as the sensitivity was 76.55%, specificity was 75%, Positive predictive value was 99.10%, Negative predictive value was 8.10%. So, the overall diagnostic accuracy was 76.51%. Practical Implication: As in our setups majority of population resides in peripheries where access to arthroscopy and magnetic resonance imaging is difficult so there is a need of clinical test for diagnosing medial meniscal tears. And this technique can be opted in routine practice for early diagnosis of medial meniscal tears in order to take proper management for reducing morbidity of these particular patients after determining the sensitivity and specificity of the test. Conclusion: This study concludes that the McMurray test had sensitivity 76.55%, specificity 75%, Positive predictive value 99.10%, Negative predictive value 8.10% and the diagnostic accuracy 76.51% in diagnosis of meniscal tear keeping knee arthroscopy as gold standard. Keywords: Arthroscopy, Knee, McMurray test, Meniscal tear, Magnetic resonance imaging.

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McMurray test

Skalina¹

2019

Radiopaedia.org

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Comparison of the Thesslay Test and McMurray Test: A Systematic Review of Comparative Diagnostic Studies

Cited by 3 publications

References 27 publications

Two Novel Clinical Tests for the Diagnosis of Hip Labral Tears

Two Novel Clinical Tests for the Diagnosis of Hip Labral Tears

Mcmurray Test for Diagnosis of the Meniscal Tears

McMurray test

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