McMurray Test | Meniscus Damage

Summary

This video tutorial introduces the McMurray Test for diagnosing meniscal damage, a procedure with a reported 63% accuracy rate according to Blyth et al.'s 2015 research. The test involves positioning the patient supine with the knee fully flexed, then rotating and extending the knee to assess the lateral meniscus. For the medial meniscus, the tibia is laterally rotated. The test is positive if it elicits clicking, locking, or pain. The video also suggests watching Apley’s and Thessaly Tests for a comprehensive assessment of meniscal damage.

Takeaways

• 🏥 The McMurray Test is used to diagnose meniscal damage in the knee.
• 🔍 A 2015 study by Blyth et al. found the test's diagnostic accuracy to be 63%.
• 🧍‍♂️ The test is conducted with the patient in a supine position with the tested knee fully flexed.
• 🔄 To test the lateral meniscus, the tibia is medially rotated and the knee is brought into extension.
• 🔄 To test the medial meniscus, the knee is fully flexed and the tibia is laterally rotated.
• 🔁 The test should be repeated with different angles of knee flexion to assess the entire posterior aspect of the meniscus.
• 🤕 A positive test result is indicated by clicking, locking, or pain in the knee.
• ⚠️ The McMurray Test is less effective for assessing the anterior half of the meniscus due to lower pressure.
• 🔗 Other tests for meniscal damage include Apley’s Test and Thessaly Test, which are also mentioned in the video.
• 👨‍🏫 The video is presented by Kai from PhysioTutors, providing educational content for physical therapy.

Q & A

What is the McMurray Test used for?

The McMurray Test is used to assess meniscal damage in the knee.

What was the diagnostic accuracy of the McMurray Test according to Blyth et al.'s 2015 research?

The diagnostic accuracy of the McMurray Test was found to be as low as 63%, meaning only 63% of patients were correctly diagnosed by musculoskeletal clinicians.

How should the patient be positioned for the McMurray Test?

The patient should be in a supine laying position with the tested knee fully flexed.

What is the procedure for testing the lateral meniscus using the McMurray Test?

To test the lateral meniscus, rotate the tibia medially and bring the knee into extension, repeating this process with different angles of knee flexion to test the whole posterior aspect.

How do you test the medial meniscus with the McMurray Test?

To test the medial meniscus, bring the knee into full flexion and laterally rotate the tibia.

Why is the McMurray Test less effective for testing the anterior half of the meniscus?

The McMurray Test is less effective for the anterior half of the meniscus because the pressure on the meniscus is not as high in this region.

What are the indications of a positive McMurray Test?

A positive McMurray Test is indicated by the patient experiencing clicking, locking, or pain in the knee.

What other tests are recommended to assess meniscal damage besides the McMurray Test?

Apley’s Test and the Thessaly Test are also recommended to assess meniscal damage.

Who is the presenter of the video on the McMurray Test?

The presenter of the video is Kai from PhysioTutors.

What are some limitations of the McMurray Test as mentioned in the script?

The script mentions that the McMurray Test has a relatively low diagnostic accuracy and is less effective for testing the anterior half of the meniscus.

What is the significance of testing different angles of knee flexion during the McMurray Test?

Testing different angles of knee flexion allows for a more comprehensive assessment of the posterior aspect of the lateral meniscus, increasing the test's diagnostic utility.

Outlines

00:00

🏥 McMurray Test for Meniscal Damage

This video discusses the McMurray Test, a diagnostic procedure for detecting meniscal damage in the knee. Despite its diagnostic accuracy being as low as 63% according to Blyth et al.'s 2015 research, it remains a valuable tool for musculoskeletal clinicians. The test involves positioning the patient supine with the knee fully flexed, then medially rotating the tibia and extending the knee to assess the lateral meniscus. To evaluate the medial meniscus, the tibia is laterally rotated from a fully flexed knee position. The test's sensitivity is limited for the anterior half of the meniscus due to lower pressure applied. A positive test result is indicated by the patient experiencing clicking, locking, or pain in the knee. The video concludes with a recommendation to also watch videos on Apley’s Test and Thessaly Test for further assessment of meniscal damage.

Keywords

💡McMurray Test

The McMurray Test is a clinical diagnostic test used to assess meniscal damage in the knee joint. It is named after Dr. McMurray, who first described the test. The test involves specific movements of the knee to detect any clicking or locking sensations that may indicate a meniscal tear. In the video, the test is described as having a diagnostic accuracy of only 63%, highlighting its limitations in clinical practice.

💡Meniscal damage

Meniscal damage refers to any injury to the menisci, which are C-shaped pieces of cartilage in the knee that provide cushioning and stability. Damage can occur due to trauma or degeneration and may result in pain, swelling, and limited mobility. The video focuses on the McMurray Test as a method for diagnosing such damage, emphasizing its importance in orthopedic assessments.

💡Supine position

In the context of the video, the supine position refers to the patient lying on their back with the tested knee fully flexed. This is the starting position for conducting the McMurray Test. The supine position is crucial as it allows the clinician to manipulate the knee joint effectively and observe for any signs of meniscal damage.

💡Tibia

The tibia is the larger, more medial bone of the two bones in the lower leg, also known as the shinbone. In the McMurray Test, the tibia is manipulated by rotating it medially and laterally to test the lateral and medial menisci, respectively. The video script instructs to rotate the tibia to assess the posterior aspect of the meniscus for potential damage.

💡Medial rotation

Medial rotation is the inward turning of the tibia, which is a part of the McMurray Test procedure to assess the medial meniscus. The video mentions that to test the medial meniscus, the tibia should be laterally rotated. This rotation helps to apply stress on the medial meniscus, which can elicit symptoms if there is damage.

💡Extension

Knee extension is the straightening of the knee joint. In the McMurray Test, the knee is brought into extension after the tibia has been rotated. This movement is essential for detecting any clicking or locking that may indicate meniscal damage, as the script describes the test being repeated with different angles of knee flexion.

💡Posterior aspect

The posterior aspect refers to the back part of a structure, in this case, the meniscus. The video script emphasizes the importance of testing the whole posterior aspect of the lateral meniscus by repeating the McMurray Test with different angles of knee flexion. This comprehensive approach increases the chances of detecting meniscal tears.

💡Anterior half

The anterior half of the meniscus is the front half of the C-shaped cartilage in the knee. The video script notes that this part is not as easily tested with the McMurray Test due to lower pressure exerted on it during the test. This highlights a limitation of the test in assessing certain areas of the meniscus.

💡Positive test

A positive test in the context of the McMurray Test indicates that the patient experiences symptoms such as clicking, locking, or pain in the knee during the test. The video script states that these symptoms suggest the presence of meniscal damage, making the test result positive and warranting further evaluation.

💡Apley’s Test

Apley’s Test is another clinical test used to assess for meniscal damage, mentioned in the video as an alternative to the McMurray Test. It involves different movements of the knee and is used to detect meniscal issues, particularly in the posterior horn of the meniscus. The video encourages viewers to watch additional content on Apley’s Test for a broader understanding of meniscal assessments.

💡Thessaly Test

The Thessaly Test is yet another clinical test for meniscal damage, referenced in the video script. It involves a specific position and movement of the knee that increases stress on the menisci, helping to identify potential tears. The video suggests watching content on the Thessaly Test alongside the McMurray Test for a comprehensive view of diagnostic methods.

Highlights

The McMurray Test is used for diagnosing meniscal damage.

Research by Blyth et al. in 2015 found the test's diagnostic accuracy to be as low as 63%.

Only 63% of patients were correctly diagnosed by musculoskeletal clinicians using this test.

The test is conducted with the patient in a supine position with the tested knee fully flexed.

The tibia is rotated medially and the knee is brought into extension to test the lateral meniscus.

The process should be repeated with different angles of knee flexion to test the entire posterior aspect of the lateral meniscus.

To test the medial meniscus, the knee is brought into full flexion and the tibia is laterally rotated.

The anterior half of the meniscus is not as easily tested due to lower pressure on the meniscus.

A positive test result is indicated by clicking, locking, or pain in the knee.

The video also recommends watching Apley’s Test and Thessaly Test for additional meniscal damage assessment.

These tests are also conducted by PhysioTutors for a comprehensive assessment of meniscal damage.

The video concludes with a reminder to watch more videos on meniscal damage assessment.

The video is presented by Kai from PhysioTutors.

The video aims to educate on the proper conduct and interpretation of the McMurray Test.

The video emphasizes the importance of testing the whole posterior aspect of the lateral meniscus.

The video provides a step-by-step guide on how to perform the McMurray Test.

The video discusses the limitations of the McMurray Test in assessing the anterior half of the meniscus.

The video suggests additional tests for a more thorough evaluation of meniscal damage.

The video is part of a series on meniscal damage assessment by PhysioTutors.

Transcripts

This is going to be a video on the McMurray Test for meniscal damage.

According to research done by Blyth et al. in 2015,

the diagnostic accuracy of this test was as low as 63%,

which means that only 63% of all patients were correctly diagnosed by musculoskeletal clinicians.

To conduct this test, have your patient in supine laying position, with the tested knee fully flexed.

Then, rotate the tibia medially

and bring the knee into extension.

You would want to repeat this process a couple of times with a different angle of knee flexion,

in order to test the whole posterior aspect of the lateral meniscus.

In order to test the medial meniscus, bring the knee into full flexion

and laterally rotate the tibia.

The anterior half of the meniscus is not as easily tested with the McMurray Test,

because the pressure on the meniscus is not as high.

This test is considered positive if your patient experiences clicking, locking or pain in the knee.

Alright guys, this was our video on the McMurray Test.

Make sure to also watch the Apley’s Test and the Thessaly Test right here, that also asses for meniscal damage.

This was Kai from PhysioTutors, see you next time, bye!