McMurray’s Test and Joint Line Tenderness for Medial Meniscus Tear: Are They Accurate?

Gupta, Yogendra; Mahara, Deepak Prakash; Lamichhane, Arjun

doi:10.4314/ejhs.v26i6.10

Cited by 15 publications

(12 citation statements)

References 18 publications

(20 reference statements)

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“…Over recent years, multiple studies have displayed a noticeable difference in diagnostic results, in regards to the McMurray's test, even though this test is widely used in clinical practice [16] . According to a meta-analysis performed by Wayne H et al in 2009, the McMurray's test has a sensitivity varied from 29 to 88% and specificity from 50 to 98% [17] .…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of clinical tests and Mri for meniscal injury in patients with anterior cruciate ligament injury: Case series study

Duong

Trung

N.T.

et al. 2021

International Journal of Surgery Case Reports

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Introduction and importance Meniscal tear is one of the most common knee injuries and knee surgery procedures. It is frequently associated with an anterior cruciate ligament (ACL) injury. We conducted this study, on patients with ACL reconstruction surgeries, which were occasionally accompanied by meniscal tears, in order to determine the diagnostic value of clinical examinations for meniscal tear, both individually and in combination, in correlations to magnetic resonance imaging (MRI) scans, with the goal of improving clinical diagnosis for patients with meniscal injuries in particular, as well as meniscal injuries associated with cruciate ligament knee injuries. Case presentation 50 patients were thoroughly clinically examined, using Joint line tenderness, Thessaly test, McMurray's test, Apley's test followed by MRI, before their scheduled ACL reconstruction arthroscopic surgeries. The meniscal tears were then identified during the procedure, and were treated, if necessary. The data before and after the surgery was taken into calculating, with arthroscopic findings serving as the gold standard. Results: the sensitivity, specificity and accuracy of each clinical tests and MRI scans respectively were: for medial meniscus, Joint line tenderness (70%; 53,3%; 60%); McMurray's test (80%; 73,3%: 76%); Apley's test (65%; 70%; 68%); Thessaly test(70%; 76,7%; 74%); MRI (90%; 83,3%; 86%); lateral meniscus: Joint line tenderness (73%; 66,7%; 70%); McMurray's test (69,2%; 75%: 72%); Apley's test (69,2%; 70,8%; 70%); Thessaly test (73,1%; 75%; 74%); MRI (88,5%; 87,5%; 88%). However, when combining at least two positive tests into a single composite test, the diagnostic value is considerably enhanced with sensitivity, specificity and accuracy of 85%, 73,3%, 78% for medial meniscus, 92,3%, 87,5%, 90% for lateral meniscus. Clinical discussion Clinical tests are essential for diagnosis of meniscal tears, although inconsistent. A composite test consisting of at least two positive tests can considerably enhance the diagnostic value, even comparable to MRI scans. However, after the clinical examination, MRI is still necessary for the diagnostic process of meniscal injuries in particular, as well as meniscal injuries associated with cruciate ligament knee injuries. Conclusion The combination of clinical tests and MRI images will give a precise diagnosis as well as surgical indication for meniscus injury in patients with anterior cruciate ligament tear.

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Section: Discussionmentioning

confidence: 99%

Diagnostic value of clinical tests and Mri for meniscal injury in patients with anterior cruciate ligament injury: Case series study

Duong

Trung

N.T.

et al. 2021

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

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“…It is essential to assess the presence or absence of meniscal pathology concomitant to ACL injuries. The diagnosis will obviously be clinical through evaluative tests that can be divided into[ 114 ]: (1) Tests that cause pain or clicks with palpation of the interline; (2) Tests that generate pain with rotation of the tibia on the femur.…”

Section: Resultsmentioning

confidence: 99%

“…There are differences in results between the researchers. Both types of evaluation tests have low diagnostic value when applied individually, increasing their usefulness when combined with the clinical history[ 114 ]. A cross-sectional study by Gobbo et al [ 115 ] in 2011, studied the sensitivity and specificity of the McMurray, Steinmann I, Steinmann II, Childress and Apley tests for both the medial and lateral meniscus.…”

Section: Resultsmentioning

confidence: 99%

Consensus Delphi study on guidelines for the assessment of anterior cruciate ligament injuries in children

Chekroun¹,

Velázquez-Saornil²,

Vicente³

et al. 2022

WJO

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Background: Knee examination guidelines in minors are intended to aid decision-making in the management of knee instability. Clinical question: A Delphi study was conducted with a formal consensus process using a validated methodology with sufficient scientific evidence. A group consensus meeting was held to develop recommendations and practical guidelines for use in the assessment of instability injuries in children. Key findings: there is a lack of evidence to analyse anterior cruciate ligament injuries in children and their subsequent surgical management if necessary. Diagnostic guidelines and clinical assessment of the patient based on a thorough examination of the knee are performed and a guide to anterior cruciate ligament exploration in children is developed. Clinical application: In the absence of a strong evidence base, these established guidelines are intended to assist in that decision-making process to help the clinician decide on the most optimal treatment with the aim of benefiting the patient as much as possible. Following this expert consensus, surgical treatment is advised when the patient has a subjective sensation of instability accompanied by a pivot shift test ++, and may include an anterior drawer test + and a Lachman test +. If these conditions are not present, the conservative approach should be chosen, as the anatomical and functional development of children, together with a physiotherapy programme, may improve the evolution of the injury.

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“…In a study by Gupta et al 24 with 66 knees to validate joint line tenderness, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy in diagnosing medial meniscus tears found to be 50%, 61.7%, 51.8%, 60% and 56.4%, respectively. 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.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Thessaly Test with Joint Line Tenderness and McMurray Test in the Diagnosis of Meniscal Tears

et al. 2020

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Introduction: Meniscus injuries are the most frequent problem of the knee. The aim of this study was to investigate the accuracy of the Thessaly test and comparing it with those of McMurray and Joint-line tenderness tests for diagnosing meniscal tears. Materials and methods: This study was designed as a prospective observational one done in an outpatient clinic at a university hospital. 106 patients with knee pain and 82 age-matched control were included during study period (from February 2014 to January 2015). Each patient was clinically examined with McMurray, Thessaly, and joint line tenderness tests. Then, the findings were matched by MRI and arthroscopic findings. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated as main outcomes. Results: Based on MRI, Thessaly was the most sensitive for medial meniscus tears (56.2%), while McMurray and joint-line tenderness were more specific (89.1% and 88.0%, respectively). For lateral meniscus tears, McMurray was the most sensitive (56.2%) and all were specific (McMurray 89.6%, Thessaly 88.4%, joint-line tenderness 90.2%). With arthroscopy, Thessaly was the most sensitive for medial meniscus (76.6%), while McMurray and joint-line tenderness were more specific (81.0%, and 81.0%). Agreement with arthroscopy was the highest with McMurray (for medial meniscus kappa=0.40, p<0.001, and for lateral meniscus kappa=0.38, p=0.002). Conclusion: The Thessaly can be used to screen for medial meniscus tears. McMurray and joint-line tenderness should be used for suspected medial meniscus tears. For lateral meniscus, McMurray is appropriate for screening and all the tests are useful in clinic.

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McMurray’s Test and Joint Line Tenderness for Medial Meniscus Tear: Are They Accurate?

Cited by 15 publications

References 18 publications

Diagnostic value of clinical tests and Mri for meniscal injury in patients with anterior cruciate ligament injury: Case series study

Diagnostic value of clinical tests and Mri for meniscal injury in patients with anterior cruciate ligament injury: Case series study

Consensus Delphi study on guidelines for the assessment of anterior cruciate ligament injuries in children

Comparison of Thessaly Test with Joint Line Tenderness and McMurray Test in the Diagnosis of Meniscal Tears

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