McMurray Test

Written by Dr Sheila Strover on March 14, 2025

The McMurray test assesses the integrity of the menisci, the crescent-shaped pair of shock absorbers in the knee. Page updated July 2024 by Dr Sheila Strover (Clinical Editor)

The surgeon feeling for a 'click' along the joint line of the knee while stressing the menisci during a McMurray test. 

Illustration of a surgeon performing the McMurray test on a supine patient, with one hand on the bent knee and the other twisting the lower leg.

How is the McMurray test performed?

The patient lies on their back with the knee bent to 90 degrees.

The surgeon uses one hand on the knee to apply a valgus force (stressing the knee inwards) while the other hand grasps the patient's foot (sole) and rotates the lower limb externally (outwards). Then the test is repeated and the opposite stresses applied.

If a click is felt or heard or the patient experiences pain, the test is considered to be positive.

"....intertester reliability using the McMurray's test is low. This is not surprising given the complicated nature of the technique and the difficulty in controlling the amount and direction of forces across testers...."

Wayne Hing et al

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What does a positive McMurray test mean?

A positive test will be recorded in the notes, but it is not highly diagnostic of a tear in the meniscus, and more investigations are likely indicated.

Conversely, a negative test means that no click or pain was elicited, but it does not necessarily mean that all is well inside the knee. The whole story needs to be taken into consideration - history of an injury, what disability was experienced after the injury, history of post-injury swelling, feelings of instability - it will all help towards making an evaluation.

In terms of other office tests, Ege's test has a better reputation for accuracy. MRI scan is considered the diagnostic investigative method of choice for meniscus tears, but it has a high cost and may pick up false positives.

"Clinical tests like McMurray and joint line tenderness have low diagnostic value when applied individually.... They may be useful when combined together with the background of clinical history."

Yogendra Gupta et al

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What is the best test for a meniscus tear?

Arthroscopy remains the gold standard for definitive diagnosis, but of course it is an invasive procedure.

During an arthroscopy, the surgeon will use a blunt probe to feel each area of the menisci for tears, as well as along the outer edge in case the meniscus has avulsed away from the capsule.

"....no clinical assessment or advanced investigations such as MRI diagnose meniscal tears in all patients....The advent of arthroscopy of the knee has revolutionalised the diagnosis and treatment of meniscal tears"

BR Mohan et al

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Why is it important to identify meniscus tears?

A torn meniscus may cause knee instability, leading to falls and possible extension of the tear, and even stressing the cruciate ligaments so they become damaged also.

Most knee surgeons would feel it important to try to stabilise the knee by repairing the meniscus where possible, but there are controversies about patient selection.

"Selecting the correct treatment can be challenging and involves multiple factors."

Simon C Mordecai et al

A-Z Keywords - Torn meniscus, Joint line tenderness, Medial meniscus tear, Lateral meniscus tear, Ege's test, Apley's test, Thessaly test, Arthroscopy, MRI, Instability, Anterior cruciate ligament injury, Meniscal avulsion

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