Accuracy of McMurray's test, modified version and joint line tenderness in diagnosing chronic meniscus tear in knee joint

Introduction: “Special clinical test” played an important role in physical examination and are thought to diagnose meniscus injury. Among those special tests, original McMurray’s test, modified version of McMurray, and joint line tenderness (JLT) are commonly used in practice. There were only lim...

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Main Author:	Choon, Teh Wai
Format:	Thesis
Language:	English
Published:	2017
Subjects:	RC Internal medicine
Online Access:	http://eprints.usm.my/45622/1/Dr.%20Teh%20Wai%20Choon-24%20pages.pdf
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spelling	my-usm-ep.456222020-10-22T03:03:13Z Accuracy of McMurray's test, modified version and joint line tenderness in diagnosing chronic meniscus tear in knee joint 2017 Choon, Teh Wai RC Internal medicine Introduction: “Special clinical test” played an important role in physical examination and are thought to diagnose meniscus injury. Among those special tests, original McMurray’s test, modified version of McMurray, and joint line tenderness (JLT) are commonly used in practice. There were only limited literatures that take into consideration of the injury time of the meniscus for the diagnostic accuracy of such clinical test. Therefore, in chronic meniscus injury the diagnostic accuracy of those special tests were unclear and questionable. Material & Method: This is a cross sectional study and 50 patients enrolled from January 2016 till June 2017. The inclusion criteria were patients had duration injury of more than 6 month, at least 16 years old or older and underwent knee arthroscopic surgery. All patients underwent physical examination first then schedule for arthroscopy performed by the same surgeon. 5 statistical parameters were calculated based on the formula: accuracy (%), sensitivity (%), specificity (%), positive predictive value (PPV %) and Negative predictive value (NPV %). Results: The mean age was 25.7 years ranging from 16 to 44 years old (SD 6.8 years). Modified version Mc-Murray test showed the highest sensitivity for both medial lesion (36.36%) and lateral lesion (35.29%). It also had highest NPV (64.10% -medial and 73.17%- lateral) and highest PPV (72.73%-medial and 66.67%-lateral). It also had highest accuracy at 66% (medial) and 72% (lateral). Original Mc-Murray test showed lowest sensitivity for lateral lesion (18.75%) however highest specificity for both lesion (92.59%-medial and 91.18%-lateral). JLT showed lowest specificity at 89.29% (medial) and 87.88% (lateral). It also showed lowest accuracy for medial lesion (60%) and same accuracy with Original Mc- Murray test at 68% for lateral lesion.Conclusion: The results indicate that Original McMurray’s test, Modified version and JLT have overall low sensitivity and high specificity in diagnosing chronic meniscal tear. It also highlights that Modified versions Mc-Murray test had highest accuracy than the original Mc- Murray test and JLT. However in clinical practice, those special tests should not standalone, but should use in combination for better accurate diagnosing chronic meniscus tear. 2017 Thesis http://eprints.usm.my/45622/ http://eprints.usm.my/45622/1/Dr.%20Teh%20Wai%20Choon-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	RC Internal medicine
spellingShingle	RC Internal medicine Choon, Teh Wai Accuracy of McMurray's test, modified version and joint line tenderness in diagnosing chronic meniscus tear in knee joint
description	Introduction: “Special clinical test” played an important role in physical examination and are thought to diagnose meniscus injury. Among those special tests, original McMurray’s test, modified version of McMurray, and joint line tenderness (JLT) are commonly used in practice. There were only limited literatures that take into consideration of the injury time of the meniscus for the diagnostic accuracy of such clinical test. Therefore, in chronic meniscus injury the diagnostic accuracy of those special tests were unclear and questionable. Material & Method: This is a cross sectional study and 50 patients enrolled from January 2016 till June 2017. The inclusion criteria were patients had duration injury of more than 6 month, at least 16 years old or older and underwent knee arthroscopic surgery. All patients underwent physical examination first then schedule for arthroscopy performed by the same surgeon. 5 statistical parameters were calculated based on the formula: accuracy (%), sensitivity (%), specificity (%), positive predictive value (PPV %) and Negative predictive value (NPV %). Results: The mean age was 25.7 years ranging from 16 to 44 years old (SD 6.8 years). Modified version Mc-Murray test showed the highest sensitivity for both medial lesion (36.36%) and lateral lesion (35.29%). It also had highest NPV (64.10% -medial and 73.17%- lateral) and highest PPV (72.73%-medial and 66.67%-lateral). It also had highest accuracy at 66% (medial) and 72% (lateral). Original Mc-Murray test showed lowest sensitivity for lateral lesion (18.75%) however highest specificity for both lesion (92.59%-medial and 91.18%-lateral). JLT showed lowest specificity at 89.29% (medial) and 87.88% (lateral). It also showed lowest accuracy for medial lesion (60%) and same accuracy with Original Mc- Murray test at 68% for lateral lesion.Conclusion: The results indicate that Original McMurray’s test, Modified version and JLT have overall low sensitivity and high specificity in diagnosing chronic meniscal tear. It also highlights that Modified versions Mc-Murray test had highest accuracy than the original Mc- Murray test and JLT. However in clinical practice, those special tests should not standalone, but should use in combination for better accurate diagnosing chronic meniscus tear.
format	Thesis
qualification_level	Master's degree
author	Choon, Teh Wai
author_facet	Choon, Teh Wai
author_sort	Choon, Teh Wai
title	Accuracy of McMurray's test, modified version and joint line tenderness in diagnosing chronic meniscus tear in knee joint
title_short	Accuracy of McMurray's test, modified version and joint line tenderness in diagnosing chronic meniscus tear in knee joint
title_full	Accuracy of McMurray's test, modified version and joint line tenderness in diagnosing chronic meniscus tear in knee joint
title_fullStr	Accuracy of McMurray's test, modified version and joint line tenderness in diagnosing chronic meniscus tear in knee joint
title_full_unstemmed	Accuracy of McMurray's test, modified version and joint line tenderness in diagnosing chronic meniscus tear in knee joint
title_sort	accuracy of mcmurray's test, modified version and joint line tenderness in diagnosing chronic meniscus tear in knee joint
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2017
url	http://eprints.usm.my/45622/1/Dr.%20Teh%20Wai%20Choon-24%20pages.pdf
_version_	1747821537000423424

Accuracy of McMurray's test, modified version and joint line tenderness in diagnosing chronic meniscus tear in knee joint

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