The reference lists in review articles were cross-checked and any possibility of name/term variations was queried using MEDLINE and PUBMED. National Library of Medicine Evans et al23 concluded that examiner experience had little effect on the accuracy of the diagnosis; however, they noted that the student examiner demonstrated a significant association (p = 0.002) between the diagnosis of a medial meniscus tear and reproduction of a medial thud, while the experienced examiner demonstrated a significant association between this diagnosis and the reproduction of pain (p = 0.008) or a medial sensation (p = 0.001). 1985;13(1):14. Harilainen A. This was also discussed by Evans et al23, who attributed their low sensitivity rates to wide patient entry criteria including differing pathologies (Table (Table44). Usually medial angulation of both femur and tibia is involved. I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. In most cases Physiopedia articles are a secondary source and so should not be used as references. Positive likelihood ratios presented in the studies reviewed generally indicated small to moderate shifts in probability (0.828.86) in that a positive test will indicate true meniscal pathology although the studies with the highest methodological quality demonstrated likelihood ratios considered to indicate moderate improvements in the probability that this will be the case3,4. MeSH Does the patient have a torn meniscus of ligament of the knee? Bearing these findings in mind, the following recommendations can be made for the clinician: This review has demonstrated that the intertester reliability and sensitivity of the McMurray's test is relatively low; however, it has also highlighted that it can be a relatively specific test, especially with respect to the lateral meniscus. Be aware of the validity issues surrounding this test. When pooled together using the bivariate random effects model (BREM), the sensitivity value of the 8 studies was 0.2 and the specificity value was 0.88. The examiner should passively bend the affected leg to about 30 degrees of flexion. Medline and CINAHL search strategy via OVID. NWI4Njg2Y2FiM2QzZGFjNjA2MjRhYTcxMTY2NmVkZmYzNTMwZDdiNTk4YTcy Meserve BB, Cleland JA, Boucher TR. Fibular Collateral Ligament: Varus Stress Radiographic Analysis Using 3 Different Clinical Techniques. Kurosaka et al6 stated that diagnostic accuracy is lessened in patients with multiple pathologies, whereas Akseki et al3 found that there was no reduction in diagnostic accuracy with an associated tear of the ACL. 1. The reported incidence of ACL sprains and tears in the knee injuries. Bookshelf OWFmOGE3YWY0OWM1ZWIzOTU5Mjg5Y2I4ODIwZmU1MmQyZWRhMmUxY2ZlMGU3 Both arthroscopy and MRI have been used as a gold standard measure for detection of meniscal injuries in knees. Current Orthopaedics. 2018 Nov 1;27(6):596-600. doi: 10.1123/jsr.2016-0188. Selection bias may occur when study subjects are not representative of the population on whom the test is typically applied in practice and can affect the results of a study11. Background: Functional hallux limitus (FHL) refers to dorsiflexion hallux mobility limitation when the first metatarsal head is under loading conditions but not in the unloaded state. High sensitivity indicates that a test can be used for excluding a condition when it is negative, but it does not address the value of a positive test. 4th ed. Studies were eligible for inclusion if they assessed measures of accuracy or validity of the McMurray's test or any modification of this test against a gold standard of either arthroscopy or magnetic resonance imaging (MRI) and were written in English. varus stress test - Medical Dictionary However, other studies have shown MRI to be no more accurate than clinical examination for the diagnosis of meniscal tears14,15. One study5 performed the test after the arthroscopy and did not state if the examiner was blinded to these results.
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