The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were then calculated by forming two-by-two cross table and using standard formula.Īnalysis of data was done using the SPSS 16 package.The statistical significance of observations were tested by the Chi square test and when needed, logistic regression analysis was performed. The clinical findings were then matched with arthroscopic findings.
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Either author, DPM or APL, performed the arthroscopies. Both DPM and APL are experienced orthopedic surgeons working in tertiary care center and are fellow of sports medicine. The examination was performed by one of the authors (DPM/APL) who was blinded to the available imaging report. Joint line tenderness was tested in 90 degree of knee flexion. The presence of pain and/or click/snap/clunk/thud was considered positive for the McMurray's test. Each patient was clinically examined with McMurray's test and joint line tenderness for clinical diagnosis of medial meniscus tear. Patients who enrolled in the study underwent a short interview regarding their symptoms, mode of injury, duration of symptoms and other demographic questionnaire. Eligible patients were requested for written informed consent before enrolling in the study.
![mcmurray meniscus test sensitivity mcmurray meniscus test sensitivity](https://www.mdpi.com/applsci/applsci-09-04102/article_deploy/html/images/applsci-09-04102-g001.png)
Cases with multiligament injury were excluded. All consecutive patients undergoing knee arthroscopy for knee symptoms (internal derangement of knee) were included. This was a prospective study done in Tribhuwan University Teaching Hospital under the Department of Orthopedics and Trauma, from February 2011 to January 2012. We hypothesized that the clinical tests of McMurray's and joint line tenderness are appropriate for diagnosing medial meniscus tear. We conducted a prospective study to evaluate the diagnostic value of McMurray's test and joint line tenderness for diagnosing medial meniscus tear. The wide variations reported have an impact on clinical decision regarding whether to go for other diagnostic tests like Magnetic Resonance Imaging (MRI) before going for diagnostic arthroscopy, which is considered as the gold standard ( 6) also the most commonly performed knee joint surgery( 7). The McMurray's test and joint line tenderness for diagnosing meniscus tear have been widely tested, but results from different authors vary. The eponymous test that is commonly performed as part of the routine knee examination in order to test for the presence of a meniscus tear is McMurray's test, which was described by McMurray in 1942 in the British Journal of Surgery ( 5). This is most often located posteromedially or posterolaterally, since most meniscus tears are in the posterior horn areas ( 4). Probably, the most important physical finding is localized tenderness along the medial or lateral joint line or over the periphery of the meniscus. If a patient does not have locking, the following signs can be important: effusion atrophy of the quadriceps, tenderness over the joint line (or the meniscus) and reproduction of a click or pain by manipulative maneuvers during the physical examination. However, locking may not be recognized unless the injured knee is compared with the opposite normal knee, which should exhibit 5 to 10 degrees of recurvatum. In the first group, locking has been classically described. The syndromes caused by tears of the menisci can be divided into two groups: that in which there is locking and the diagnosis is clear and that in which locking is absent and the diagnosis is more difficult. The onset of symptoms and mechanism of injury are often clues to the diagnosis. The diagnosis of meniscus tear can frequently be made from a careful history, physical examination and appropriate diagnostic tests. The acute tears frequently result from sports injuries where there is a twisting motion on the partially flexed, weight-bearing knee ( 3). Meniscal tears may occur in acute knee injuries in younger patients or as part of a degenerative process in older individuals.
![mcmurray meniscus test sensitivity mcmurray meniscus test sensitivity](https://i.ytimg.com/vi/YStEOzhFDU4/maxresdefault.jpg)
![mcmurray meniscus test sensitivity mcmurray meniscus test sensitivity](https://www.mdpi.com/applsci/applsci-09-04102/article_deploy/html/images/applsci-09-04102-g005.png)
Medial meniscus tears are generally seen more frequently than tears of the lateral meniscus, with a ratio of approximately 2:1 ( 2). Meniscal tears are the most common injury of the knee ( 1).