McMurray Test: How to Detect Meniscus Injuries with This Classic Maneuver

The McMurray test is, along with the Apley test, probably the maneuver most associated in any clinician's mind with the word "meniscus." Its goal is to trap the injured meniscal fragment between the femoral condyles and the tibia, reproducing the pain or the characteristic "click" that patients so often describe.

What does this test measure?

The McMurray test aims to reproduce pain, locking, or a palpable click by combining deep knee flexion with tibial rotation and a valgus or varus force, attempting to "pinch" a damaged meniscal fragment between the joint surfaces.

Depending on the combination of rotation and force applied, it points more toward the medial meniscus or the lateral meniscus.

Equipment needed

• Treatment table
• No additional tools required

Execution protocol

1. The patient lies supine. Stand next to the leg being assessed
2. Flex the knee as much as possible, holding the foot/ankle with one hand and the knee (with your fingers on the joint line) with the other
3. For the medial meniscus: apply external tibial rotation + valgus force, and slowly extend the knee from maximum flexion down to about 90°
4. For the lateral meniscus: apply internal tibial rotation + varus force, and repeat the same gradual extension
5. Throughout the movement, palpate the joint line and listen/feel for a click accompanied by pain

Common mistakes

• Not maintaining constant rotational/varus-valgus pressure throughout the entire movement
• Mistaking a painless click (very common and clinically insignificant) for a painful one (the one that matters)
• Failing to clearly distinguish whether the pain/click occurs on the medial or lateral side

How to interpret the result

Result	Interpretation
Palpable/audible click with pain on the medial joint line (external rotation + valgus)	Positive — suggests a medial meniscus injury
Palpable/audible click with pain on the lateral joint line (internal rotation + varus)	Positive — suggests a lateral meniscus injury
Click without pain, or no click	Negative (a painless click alone is not considered positive)

The McMurray test has good specificity when clearly positive (click + reproduced pain), but limited sensitivity, so a negative result does not rule out a meniscus injury. If clinical suspicion remains, consider referral for an MRI.

Related tests

McMurray is part of the classic meniscal triad alongside:

• Apley test — adds a distraction phase to distinguish meniscal from ligamentous origin
• Thessaly test — a weight-bearing functional version, useful when McMurray is inconclusive

Track pain and its location

With meniscus injuries, knowing which compartment and with which movements pain appears over the weeks gives you clues about progression (is it improving with conservative treatment or not?). In Movalytics you can log the McMurray test result along with notes on pain location and compare progress across assessments.

Frequently asked questions

Does the McMurray test hurt the patient? If positive, yes — it reproduces the pain the patient usually feels with twisting or deep flexion in daily life. Does a click without pain mean there's a meniscus injury? Not necessarily. Painless joint clicks are very common and, on their own, are not considered a pathological sign. Can this test be done in the acute phase with significant swelling? It's harder, because deep knee flexion is usually limited by pain and inflammation. Sometimes it's better to wait for the swelling to subside for a more reliable assessment.