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Accuracy of McMurray and Joint Line Tenderness Tests in the Diagnosis of Chronic Meniscal Tears: An Ad Hoc Receiver Operator Characteristic Analysis Approach

  • Marco Galli
    Correspondence
    Corresponding author Marco Galli, MD, Department of Geriatrics, Neurosciences and Orthopedics, Teaching Hospital “Agostino Gemelli”, Catholic University of the Sacred Heart School of Medicine, Rome 00168, Italy.
    Affiliations
    Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Rome, Italy
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  • Emanuele Marzetti
    Affiliations
    Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart School of Medicine, Rome, Italy
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Published:October 19, 2016DOI:https://doi.org/10.1016/j.apmr.2016.09.122

      Highlights

      • The diagnostic value of diagnostic tests for detecting meniscal tears is debated.
      • The McMurray test is more accurate than the joint line tenderness test.
      • The accuracy of the McMurray test is low to moderate.
      • The McMurray is useful in patients with highly suspected meniscal tears.

      Abstract

      Objective

      To determine the overall diagnostic accuracy of the McMurray and joint line tenderness (JLT) tests for the detection of meniscal lesions.

      Design

      Secondary analysis of a prospective observational study.

      Setting

      Orthopedics outpatient clinic, university hospital.

      Participants

      Patients (N=56) with suspected nonacute meniscal lesions who underwent knee arthroscopy.

      Interventions

      Not applicable.

      Main Outcome Measures

      Diagnostic accuracy of the McMurray and JLT tests as determined by receiver operator characteristic analysis.

      Results

      The McMurray test showed higher accuracy (area under the curve [AUC], .69; SE, .079) than the JLT test (AUC, .58; SE, .084).

      Conclusions

      The McMurray test, although presenting a higher diagnostic accuracy than the JLT test, does not suffice as a standalone diagnostic procedure for chronic meniscal lesions. The test may still be valuable to guide the diagnosis in cases with highly suspected meniscal tears.

      Keywords

      List of abbreviations:

      AUC (area under the curve), JLT (joint line tenderness), ROC (receiver operating characteristic)
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