The McMurray test is a hands-on knee exam that healthcare providers use to check for a torn meniscus. Your meniscus is a rubbery wedge of cartilage that sits between your thighbone and shinbone, acting as a shock absorber. During the test, a provider moves your leg through a series of rotations and extensions designed to put mild stress on that cartilage. If the movements produce a click, a catching sensation, or pain along the joint line, the test suggests a tear.
What Happens During the Test
You’ll lie flat on your back on an exam table with your leg relaxed. The examiner places one hand on your heel and the other along the joint line of your knee, where the edges of the cartilage sit just beneath the skin. From there, the test follows a specific sequence.
First, the examiner bends your knee as far as it will comfortably go. To check the medial meniscus (the cartilage on the inner side of your knee), they rotate your lower leg outward while applying gentle pressure inward on the joint. Then they slowly straighten the knee while holding that rotation. To check the lateral meniscus (the outer side), they rotate your lower leg inward instead and apply outward pressure. Throughout these movements, the examiner is feeling for any clicking, popping, or grinding under their fingertips, and watching your reaction for signs of pain.
The whole process takes only a minute or two per knee. The idea is that rotating and extending the joint traps or pinches a torn piece of cartilage between the bones, producing a mechanical response that wouldn’t happen in a healthy knee.
What a Positive Result Means
A positive McMurray test typically involves a palpable click or thud that the examiner can feel at the joint line, often accompanied by pain in that same spot. The location of the response helps narrow down which meniscus is injured. A click during outward rotation points to the inner meniscus, while a click during inward rotation suggests the outer meniscus.
A positive result doesn’t guarantee a tear on its own. Several other knee conditions can trigger a similar response and produce a false positive. Osteoarthritis, a torn ACL, previous knee surgery, and mechanical locking of the knee can all interfere with the results. Rheumatic diseases and prior joint fractures are also known to mimic a positive finding. This is why the McMurray test is one piece of a larger evaluation, not a standalone diagnosis.
How Accurate Is It
The McMurray test’s accuracy depends heavily on when it’s performed. A diagnostic accuracy study of 255 patients published in Acta Orthopaedica found that sensitivity (how well the test catches actual tears) was 91% when performed within the first week after injury, dropping to 80% at four to five weeks. Specificity (how well it correctly rules out tears) moved in the opposite direction, rising from 55% in the first week to 79% a few weeks later. The test’s positive predictive value, meaning the likelihood that a positive result truly reflects a tear, reached 92% at the later time point.
Those numbers are better than what older literature had reported. Earlier studies placed sensitivity as low as 16% and as high as 71%, with specificity ranging from 71% to 98%. The wide spread likely reflects differences in technique between examiners and the populations being tested. Among the six common meniscal tests evaluated in that study, the McMurray showed the most balanced overall performance.
Limitations in the Acute Setting
If your knee is swollen, painful, or too stiff to bend fully, the McMurray test may not work well. Pain and fluid buildup (effusion) can limit how far the examiner can move your leg, making the results unreliable. The American Academy of Family Physicians notes that both the McMurray and the Thessaly test (an alternative where you stand and twist on the affected leg) are often limited in the early days after an injury because patients can’t tolerate the movements. In those cases, the provider may wait for swelling to go down and repeat the test later, or skip straight to imaging.
The AAFP’s guidance actually favors the Thessaly test over the McMurray during initial evaluation for meniscal injuries, though both share the same practical limitation: they’re hard to perform when the knee is acutely inflamed.
What Comes After the Test
If the McMurray test is positive and your symptoms line up (joint-line tenderness, catching or locking in the knee, pain with deep squatting), your provider will likely order an MRI to confirm the tear and see its size and location. The McMurray test is a screening tool, not a replacement for imaging. Current clinical guidelines from 2025 recommend using it alongside the modified McMurray test and the Thessaly test as part of the physical exam to confirm a suspected meniscal injury before deciding on next steps.
If the test is negative but your symptoms persist, that doesn’t rule out a tear. Given the test’s sensitivity limitations, a negative result with ongoing knee pain, swelling, or mechanical symptoms still warrants further investigation. The test is most useful when it’s positive, particularly when performed a few weeks after the initial injury, when swelling has subsided and the joint can move through its full range.