McMurray Test | Meniscus Damage
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- Опубліковано 24 сер 2024
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This is not medical advice. The content is intended as educational content for healthcare professionals and students. If you are a patient, seek care of a healthcare professional. Kai demonstrates the McMurray Test for meniscus damage! Check out the Apley's and Thessaly Test at the end of this video or by clicking the "i" in the top right corner!
Smith et al. (2015): www.ncbi.nlm.n...
Hegedus et al. (2007):
www.ncbi.nlm.n...
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accurate, short to the point, and i find ur videos extremely useful. I solely rely on ur videos for the USMLE step 1 and 2 knee examinations and it is more than enough. never had a chance to say thank you🤗 you guys are awesome really
+Pete Htwe that's awesome to hear! We put a lot of thought in how to set up the videos! Glad you like it
Yeees i also used it for my step prep 🤓
thank you so much for all these videos. every time I encounter these maneuvers anywhere on my USMLE step 2 review (uworld, first aid, NBME) I go straight to your channel to help me remember better. BIG HELP and definitely sharing this to my friends :)
Thanks for sharing and good luck with your review
Hi doc!!
@@jamesalipio1631 she’s not interested bruh
Hi guys, I just got my result and found out I passed after multiple humiliating unsuccessful attempts. I found your videos really helpful and was watching them quite a lot during the preparation. Thank you and god bless you!!!!
Wow, very happy to hear we could help you to pass! Failing a test is the best way to really learn and never forget!
I keep coming back to your videos every semester. I have so much appreciation for this channel
Happy to hear that!
Had an exam where this test came up, thanks to you i passed. Thanks guys love you
Great Youri!Congrats!
Love how short and to the point these videos are and giving all of the important information needed. You guys helped me tremendously through my medical program and studying for my boards exams. Thank you so much!
You guys are amazing. Currently a MS4 going into FM. Brushing up on my ortho skills. THANK YOU.
How many of you are here from plabable in 2023?
lol. Plabable 2024
Ya😂@@giseleabissegue
2024😂
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2024😂
I like when he does the videos straight to the point no too much talk. Thank you 👍👍
You have to keep the other hand( thumb/fingers) at the joint line to palpate for the click
Yeah, there is different descriptions for the execution of the McMurray test with some describing the palpation of the joint line for a palpable click.
Others (like us) focus more on valgus force, which is why our hand is placed like shown in the video.
A click can be heard (by the examiner or patient) or felt by the patient for the test to be positive.
@@Physiotutors ourself have to feel the click, if only focus on ear it or ask the patient if he feels it, is a mistake, becauce we are searching a sign (somethig who we can value such as objetive, not like a symptom, when the patients refere it)
Thank you for making all of these videos! It's really helping me in massage therapy school.
These videos are great for USMLE Step 2 and beyond!!! Underrated!!!
0:34 lateral meniscus
1:00 medial meniscus
You say in this video that you are testing the lateral meniscus when you flexed the knee AND internally rotated the lower leg. However, in your joint line tenderness palpation video you state that external rotation of the lower leg exposes the lateral meniscus. Could you please confirm which is correct? Thank you.
You say in the video: 'you want to repeat this movement a couple of times with a different angle of knee flexion.' Can you explain further what you mean? The knee is moved through full flexion in every one of your movements.
When my ortho did the McMurray test it was neg. it was 10 days after I injured it. MRI showed complex radial meniscus tear, a Baker's cyst & bone contusion and loose bodies & tissue edema. I had a partial meniscectomy 6 mos. later. Also my knee never swelled up at all.
I watch your videos and teach my students. It makes everything so much easier for me
These videos are so helpful and to the point . Thank you guys❤
Lateral rotation with slight abduction .Clicking locking of knee can be felt if you palpate and fix medial joint line.
I think your left fingers should be on meniscus line. Besides, externally rotate the tibia introduce a valgus force, and extend the knee for medial meniscus. With the tibia internally rotated and a varus force applied to the knee for lateral meniscus
There are quite a few different descriptions of this test. We stuck to the one in Magee where the test is explained without a valgus/varus force and just adds external/internal rotation.
Won't valgus stress compress lateral meniscus, while relieving the medial meniscus. It seems like you should perform ER + varus to stress medial meniscus, and IR + valgus to stress lateral meniscus.
@@robertyoder5477 That is how I apply the maneuver as an MD. Sounds like they are going for a "textbook" application.
@@robertyoder5477 no because the MCL is stretched when applying valgus force, and because it is connected to the MEDIAL meniscus it will stretch it too, causing pain
@@robertyoder5477 This is how I learned to do it too.
for MM: externally rotate tibia and force valgus on knee then extend. for LM: internally rotate tibia and do varus on knee then extend.
Thanks for the input hati. This is not how is described in the literature we used though and literature is conflicting about internal or external rotation for the medial or lateral meniscus.
Isn´t he just reiterating what you showed in the video?
Yes, but no valgus/varus is described in the original test
why you still putting your hand on lat side of knee when testing the medial meniscus I saw different techniques to this test
There are different techniques. This one does not utilize varus or valgus force.
good example of the test, but I would also palpate the joint lines to feel for the grinding, clicking, popping also.
Thanks Adam. There are many different versions of the McMurray in the liaterature and the original version is without palpation of the joint line. Have contempleted to remake this video and mention that there are quite a couple of different versions and we are getting a lot of comments on it!
Thanks
Guys, thank you so much for your videos - they are incredibly informative. I will be sending all the students and clinicians I work with in the direction of your channel. They are really helpful in learning and revision!
Thanks a lot for the kind comment! Appreciate you spreading the work about the work that we do! We have a lot of different resources across social media (Facebook and instagram) that’s beyond the videos as well as our ebook and mobile app that could be of value to students and clinicians
Cheers,
Andreas & Kai
thank you so much for these excellent short straight-to-the-point videos :)
You’re welcome
Sir I'm a Judoka and had a direct knee striking throw on mat, it's been more than 18 days and yet pain is not over, pain isn't that hard but I feel some pain while bending my knees and walking too, and I'm afraid that whether I have a meniscus tear or not!
supine
tibia medial = posterior aspect of lateral meniscus
lateral rotation of tibia medial = medial meniscus
When laterally rotating the tibia, your hand should be on medial menisci so to feel the crepts or clicks, if present
Thanks for the pointer 👍🏼
Do you know how to check MRI report brother
Have you thought of making a video about the Steinman tendersness displacement test? It is supposed to test for medial meniscus leasion in the anterior horn. However i have not done any research to the specificity or sensitivity of it, so it might not be useful.
great video, In surgery lateral rotation is called external rotation
Thx, both terms are synonymous
Marksmann In everywhere lateral rotation is external rotation. The terms are used interchangeably
Valgus force and ER for medial meniscus, varus force andIR for lateral meniscus ...but you may be different? ??
AYO WHERE CAN I GET UR INTRO ITS SICK!!
Are you applying a valgus force at the knee as well, when performing this test?
I thought so too, but here they rotate the knee joint instead
Ejecución incorrecta del test
Pol said youre wrong
i like the modification to this to be done prone, applying pressure to the joint trough tibia.
Isn't that the medial meniscus can be tested by both medial and lateral rotation of the knee ?
Mcmurray should include repentine external and internal rotations of the tibia while adding a component of adduction and abduction of it. Also, the compression from the bottom should be higher.
There's different descriptions of this test in the literature and that's one version of how McMurray describes it.
We're receiving the feedback your give quite often, which is why we are considering a new version of the video that includes those versions. Thanks for the input Francesco!
Should'nt you mention, that there is also a varus and valgus Stress during your movement in extension? and why do you give twice a valgus stress? should be once a varus stress, shouldn't' it?
I appreciate all of your ortho videos & need to work out @ your gym 😁
Thanks 😊 guess any gym will do haha
Thank you
You’re welcome Mariam
when you make a assessment of lateral meniscus you need to rotate the tibia internal and to assesment of medial meniscus do a external rotation. I see that you dont do this, was for some reason?. That movements used while the execution of the test improve the accuracy.
by the way Nice videos guys . keep the good work . I hope see more tests here.
We are mentioning (and doing) that in the video.
Only thing that is optional and described sometimes is abduction or adduction as well.
Our channel is full of special tests, just have a look!
I think you exchanged 2 terms if I'm not in mistake: if you test menuscus' posterior parts by this test you test lateral meniscus with tibial external rotation and medial one with internal rotation. Don't you?
Nope, originally the McMurray test is positive for the medial meniscus with external rotation and vice versa.
Kim et al. (1996) also describe that a medial meniscus tear might be diagnosed with medial rotation and the lateral with lateral rotation which they call the paradoxical McMurray test.
@@Physiotutors Thank you so much! Your page is really great!!!
Thanks for your movies. It is very helpful to my practice!!
That's why we make them!
Love you guys. Good job with this videos!
감사합니다
Very nice video.. Thanks
Thank you !
Nice
Can you show us also the other part of Mc Murray Test with Varus - External/Internal Rotation?
(how can I hold the knee to give efficient inputs without saging the knee and with an ergonomic attitude for a physiotherapist)
Thanks a lot - you're have helpful videos ☺
Hey Michelle, the addition of the varus force is another way to perform the McMurray's - internal and external rotation is a must!
Not exactly sure what you mean with "saging the knee" though. Can you explain?
And no worries! thanks a lot for following us!
Sir please also upload some stretching or strengthen exercises for the related problem thank you
A gradual lower extremity strengthening program will help. If treated conservatively, calm down the knee and then build up the load
We will upload more and more exercise/interventions videos! For now, check the exercise playlist on the channel
why do you not put valgus/varus force on the knee
thank you for helping us (students)
good teaching
Quick question; doesn't his hand need to be on the medial side of the knee to test the medial meniscus? 🤔
Hello! Shouldn't it be medial rotation of the tibia + varus to test the lateral meniscus? Instead of valgus?
The originial description by McMurray is without any valgus and varus. In the video we just guide the knee without giving a valgus force. But you are right, that for example Gillis and Edwardson describe internal rotation+varus force to test the lateral meniscus.
Okay thank you very much!
This is really helpful
Thanks Justin 😊
Thank you!!
Hello, is it possible to ask if you can make a video about steinman’s test? Thank you
We'll put in on our (extensive) list! Definitely one to cover...
Thank you!
Cheers 👍🏼
thank youuuuuuuu this was very helpful
한국어 자막 있어요 좋아요!!♡
Thank you!
오 한국어자막👍👍👍
00:29 where it starts
Thank you sir
당신들 정말 최고에요 최고최고최고!!!!
Thanks a lot Hyeong!
thank you. .
Ty it really helps in OT
Hi. Have you any pearls of wisdom regarding appropriate special tests for what appears to be a painful knee medial snapping syndrome? McMurrays test for meniscal damage is negative, and all knee ligament stress tests are unremarkable. A snapping is both visible and palpable over the pes anserine region. A literature search has turned up no clinical tests, only a recommendation of dynamic ultrasound and surgical management of a rarely diagnosed snapping pes anserine. Functionally, the knee " painfully collapses when carrying a load down stairs, and occasionally on walking"
Never encountered it in patients to be honest. So with lack of scientific evidence it's hard to give you any advice here.
Medial plica syndrome? You can roll over those with your fingers if they are really bad.
I have knee popping when I do the test but no pain
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Hi, for research purposes, if a patient has a locked knee, would a McMurray test still be done?
Excellent,it's really useful for me ♥️
I have had bilateral and sometimes unilateral tingling from shoulder to arm for some time. To differentiate between tos and carpal tunnel syndrome
Which test do helping?
wish me luck guys on my exam tom
Gud afternoon sir I want u to make a video on non weight bearing hip adductor strengthening exercise in sitting position
Hm, just take a small swiss ball between your legs and squeeze it for example
u are the best sir great tips
Hello ! I was at the doctor, did Mri. they found a tear at the top of the medial meniscus. the doctor does surgery (orthoscopy). Therefore, he offers surgery. I want to try without surgery. Question: can a torn meniscus grind bone cartilage?
For any personal health or rehab questions we recommend to consult with our partners at yourphysio.online for a remote physiotherapy consultation.
Nice content thank you !
Amazing guys
Thanks 🤗💜💜💜💜
Appreciate it Yasmin!
Thank u
Please can you write what is the journal title!?
+PDC Ghada Check The Video description for info on the literature as well as a link to the article
Excellant work
Nice video 👍
You're not adding valgus or varus stress during extension
Valgus/varus is not performed in the original description of the mcmurray test
Hello, I did this test and upon external rotation of tibia I experienced some pain, which indicates a possible medial meniscus tear. However, during palpation it was in fact the lateral region where the lateral meniscus was located that was tender (and the medial side was completely painless). What gives?
You have to realize that all meniscus tests have limited accuracy. This means that one single positive test doesn't have to mean much in general. Kim et al. describe that lateral rotation could also stress the lateral meniscus and explain their mechanistic logic behind it here: www.ncbi.nlm.nih.gov/pubmed/8638759
Ok, thanks for the reply. May I know how common is it for meniscus tear symptoms to go away completely after 24-36 hours of initial pain? I tested positive for McMurray's and Thessaly's, but within about a day all the pain was gone. Could I have misdiagnosed myself?
ChowMeinChowdown Short answer is yes. Meniscus tears dont just resolve in a day. You likely had a small sprain of the LCL, maybe IT band was sore, who the heck knows. If you’re truly worried about your pain and RICE doesnt resolve it (rest, ice, compression, elevation) + NSAIDs (ibuprofen, naproxen) or Tylenol dont resolve it then go to the doctor. Stop diagnosing yourself through UA-cam videos.
the outer 1/3 is vascularized and therefore self limiting/healing the inner 2/3 and would require surgical repair. regardless if its inner or outer part, it wont resolve in a day. i second these guys MRI would be more accurate. these test are just one of few to r/i , r/o which structures are most likely involved. foreign object lodged in there would also present with meniscal ssx - ie locking and pain.
carlos n'a pas compris
Can you upload a video on pelvic tightness and leg muscles stretch for males with hard flaccid syndrome. Please I'm dying here
Thank uuu frome Algeria
Really helpful
+NTA Fitness you're welcome 😊
U guys are superbbb.. Done great job.. ♥️.. U r ♥️
Thanks guys! You are the best! Kai, you are a cotton candy to my eyes. Haha.
Ur welcome! Haha thx, we're trying our best to make our videos visually appealing!;)
What is therapy for meniscus problem (positive test in this case)?
Graded exercise therapy. In case of severe locking, meniscectomy surgery is possible.
The diagnosis is not only based on a single test result though
This video is amazing! Thanks for uploading them. 21/12/2018 😃😃
انت كمان تدرسي معالجة فيزيائيه؟
You should provide both a varus and valgus force at the knee with both IR and ER of the tibia for a more effective screen. Cheers
In the original description of the McMurray no valgus/varus is mentioned
I've had this done and it caused pain on the side of the kneecap. MRI showed no meniscus damage. Very odd as two months later it did not cause pain when repeated. Knees are a funny one
If you are below 40, minor meniscus tears should heal.
@@gogadev it's a weird one, the MRI reported nothing on my meniscus, just fat pad impingement.
@@roy6419 Glad youre ok.
Great!👌
Any good orthopedic books you guys recommend for primary care?
check the video description for our own orthopaedic assessment e-book
this can use for mcl test? hope you notice me :) i have an assignment about this 🥰
No
You’ll use the valgus stress test for the MCL
@@Physiotutors what are the other test for mcl other than valgus?