During the McMurray test, pain or a click with valgus stress and external rotation indicates a tear of which meniscus?

During the McMurray test, pain or a click with valgus stress and external rotation indicates a tear of which meniscus?

• A. Medial meniscus tear
• B. Lateral meniscus tear
• C. ACL tear
• D. MCL tear

Answer: (A)

The maneuver that combines external rotation of the tibia with valgus stress during the McMurray test stresses the medial meniscus. The medial meniscus is more firmly attached to the medial collateral ligament and the joint capsule, making it less mobile. When the knee is extended from flexion with the tibia externally rotated and the medial side stressed, the torn medial meniscal edge can catch between the femur and tibia, producing a painful click or reproduction of symptoms. This pattern localizes to the medial meniscus tear. In contrast, the lateral meniscus is more mobile and is typically tested with internal rotation and varus stress. Tears of the ACL or MCL have different signs and would not be expected to produce the same click/pain pattern during this specific McMurray maneuver.

The maneuver that combines external rotation of the tibia with valgus stress during the McMurray test stresses the medial meniscus. The medial meniscus is more firmly attached to the medial collateral ligament and the joint capsule, making it less mobile. When the knee is extended from flexion with the tibia externally rotated and the medial side stressed, the torn medial meniscal edge can catch between the femur and tibia, producing a painful click or reproduction of symptoms. This pattern localizes to the medial meniscus tear.

In contrast, the lateral meniscus is more mobile and is typically tested with internal rotation and varus stress. Tears of the ACL or MCL have different signs and would not be expected to produce the same click/pain pattern during this specific McMurray maneuver.