McMurray Test: A Clinical Guide for Assessing Meniscal Injuries

The McMurray Test remains one of the most commonly taught and applied orthopedic assessments for identifying meniscal tears in the knee. Though advanced imaging options have become more accessible, physical therapists and other musculoskeletal providers continue to rely on functional tests like McMurray to inform triage, diagnosis, and care planning.

This article outlines the purpose of the McMurray Test, describes how it is performed, discusses diagnostic accuracy, and highlights how it can inform clinical decision-making in rehabilitation and orthopedic care settings.

What Is the McMurray Test?

The McMurray Test is a passive orthopedic test used to assess the integrity of the menisci—C-shaped cartilage structures that cushion and stabilize the knee joint. During the test, the clinician applies rotational and valgus or varus stresses to the knee joint while it is moved through flexion and extension. This maneuver may compress a torn portion of the meniscus between the femur and tibia, triggering a palpable click or reproduction of pain.

A positive McMurray Test typically presents with:

• A palpable or audible click

• Reproduction of joint line pain

• Patient-reported catching or locking sensations

The test is often used when patients present with mechanical symptoms, joint line tenderness, or a history of rotational injury to the knee, which is common in athletic and post-traumatic cases.

How To Perform the McMurray Test

The correct technique is essential for reliable interpretation. The test is performed with the patient lying supine:

1. The examiner fully flexes the knee and hip.

2. To assess the medial meniscus, the tibia is externally rotated while a valgus stress is applied. The knee is then slowly extended.

3. To assess the lateral meniscus, the tibia is internally rotated with a varus stress applied during knee extension.

The test is considered positive if the patient experiences pain, clicking, or catching during the maneuver. While commonly used in physical therapy evaluations, it is more accurate when clinicians are trained in precise positioning and patient handling.

Diagnostic Accuracy and Clinical Value

While widely adopted in clinical practice, the McMurray Test varies in its diagnostic performance. According to a 2017 meta-analysis of clinical meniscal tests, the McMurray Test demonstrates higher specificity than sensitivity. This means a positive result may help confirm a meniscal tear, but a negative result does not reliably exclude one.¹

When used alongside other tests—such as joint line palpation or the Thessaly test—accuracy improves. Combining physical exam findings with clinical history and imaging (if necessary) can help guide more confident decisions about conservative care versus orthopedic referral.

When to Use the McMurray Test in Practice

The McMurray Test remains a helpful part of a clinician’s orthopedic assessment toolkit, especially in outpatient rehabilitation, sports medicine, and post-surgical screening. Common use cases include:

• Initial screening for meniscal injury in patients with non-specific knee pain

• Monitoring symptom resolution in non-operative meniscal care plans

• Supporting referral decisions when mechanical symptoms persist or escalate

However, providers should be cautious when interpreting the test in patients with high muscle tone, swelling, or acute joint irritation. These factors may lead to false positives or mask clinical findings.

The McMurray Test offers clinicians a functional way to assess for meniscal pathology during a knee examination. While not definitive on its own, it can provide valuable insight when paired with history and additional assessment tools. For physical therapists and orthopedic care teams, this test supports decision-making around conservative management, return-to-activity timelines, and the need for surgical consultation.

Explore More Evidence-Based Orthopedic Exams

The Jobe Test / Empty Can Test is just one of many tools available to help clinicians diagnose and manage musculoskeletal conditions with greater precision. At Medbridge, we equip providers with the knowledge and resources they need to elevate care—from exam technique to evidence-informed decision-making.

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References

1. Meserve, B. B., Cleland, J. A., & Boucher, T. R. (2017). A meta-analysis examining clinical test performance for assessing meniscal injury. North American Journal of Sports Physical Therapy, 12(2), 97–104. https://pmc.ncbi.nlm.nih.gov/articles/PMC5389077/

2. McMurray Test. ScienceDirect Topics. https://www.sciencedirect.com/topics/neuroscience/mcmurray-test