varus stress test - Medical Dictionary Edinburgh: Elsevier, 2006. IR of the tibia + Varus stress = lateral meniscus, ER of the tibia + Valgus stress = medial meniscus. OWFmOGE3YWY0OWM1ZWIzOTU5Mjg5Y2I4ODIwZmU1MmQyZWRhMmUxY2ZlMGU3 As the knee goes into flexion, the LCL loses its significance and influence as a varus-stabilizing structure. The test is fairly solid. ZTE1ZTU0YzgxZTBhZGFlNGI5YzcyODQ4YjdhNTE5Yzc0MmMzMTI2YmQ5M2E1 Operational definitions of diagnostic accuracy terms used in the studies investigating validity of McMurray's test for meniscal pathology (modified from Powell & huijbregts10). and transmitted securely. A control group was composed of patients with an MRI and intact ACL and FCL. -----END REPORT-----. Medline and CINAHL search strategy via OVID. Akseki et al3 compared the McMurray's test with a weight-bearing version of the McMurray's test that incorporated axial compression and varus/valgus stress, with the patient squatting down in internal and then external rotation (Ege's test). Authors of 9 studies examined the Lachman test and reported sensitivity values ranging from 0.63-0.93 and specificity values ranging from 0.55-0.99. If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. Orthop J Sports Med. Sensitivity: 25%. Accuracy is the percentage of subjects who are correctly identified as either having or not having a meniscal tear. OThmMmM0YTcwMmQwODZhZWFkYzNjNzRlOTkzZiIsInNpZ25hdHVyZSI6IjVh 2018 Nov 1;27(6):596-600. doi: 10.1123/jsr.2016-0188. (PDF) Physical examination of the elbow, what is the evidence? A [2]Meniscal tears may occur in acute knee injuries in younger patients or as part of a degenerative process in older individuals. NWI4Njg2Y2FiM2QzZGFjNjA2MjRhYTcxMTY2NmVkZmYzNTMwZDdiNTk4YTcy Bethesda, MD 20894, Web Policies A recent meta-analysis illustrates the difference in test characteristics when performed on patients under anesthesia. The same maneuvers are performed in gradually increasing degrees of knee flexion to progressively load more posterior segments of the menisci. Further, the description of the test itself should be well explained, and improving intertester reliability in the future would increase the validity of the studies. In: Campbell's Operative Orthopaedics. This is a key test to perform when assessing for posterolateral instability of the knee. The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user. Physiopedia is not a substitute for professional advice or expert medical services from a qualified healthcare provider. Anderson AF, Lipscomb AB. [4, 6] Thessaly Test. True positive: the person has the disease and the test is positive. followers. Acute patients (< 6 weeks) excluded. ZmZjN2MzNzdhZDFlZWY2OGI0YWExNTViZjA5ZDc3OTA3MTJmYTYyOGFmMGEw Elbow Varus Instability Stress TestLateral Collateral Ligament 1. A positive test is considered to be a thud or click that can sometimes be heard but can always be felt4 (Figure (Figure11). ODU2Y2M1MDM5YjZiZGYwM2E5ZDEyYjk5Nzc0MTA0ZWQxYmE5MmJiMjRlYWQ2 Human Kinetics, 2008. Malanga GA, Andrus S, Nadler SF, McLean J. Background and Objectives: Clinically, it is beneficial to determine the knee osteoarthritis (OA) subtype that responds well to conservative treatments. Patient in supine. NzM3NDQ2NDMzYThiNjlhNjA0M2M3MzVlMWFhYmE5ZDI3ZTI0YTIyZGIyNWM4 The remaining four studies failed to mention what denoted a positive test (Table (Table4).4). The reliability of this test in extension is 68% and in 30 flexion only 56%. 1987; 76: 269-273. How to appraise a diagnostic test. Varus Stress Test of the Knee: Genu Varum (aka bow-leggedness, bandiness, bandy-leg, and tibia vara), is a physical deformity marked by (outward) bowing of the lower leg in relation to the thigh, giving the appearance of an archer's bow. 2nd ed. Under the original description of the test, a thud or a click felt by the examiner (and sometimes heard) while performing the test was considered positive (McMurray as cited in Corea et al4). Value of the physical examination. The review also highlights the idea that modified versions of the test seem to be more valid than the original version. . However, only Kurosaka et al6 and Evans et al23 made it clear that the examiners were not given any details about the subject's history so that they would not be influenced by this information. Would you like email updates of new search results? Sensitivity is the probability of a positive test result in someone with the pathology, whereas specificity is the probability of a negative test result in someone without the pathology.6Traditionally, tests which have high sensitivity values are able to correctly identify individuals with the pathology; thus, if the examiner obtains a negative Be aware of the validity issues surrounding this test. Physical examination of the knee, inThe Sports Medicine Resource Manual, Editors: Seidenberg, P.H & Beutler, A..I. The description should include the exact details of the test's application and the criteria used to determine positive and negative results11. In an analysis of 20 available studies, the mean sensitivity and specificity of the anterior drawer test were 38% to 81% in awake patients and 63% to 91% in anesthetized patients, respectively. ZDZkZjczMGZkNzQ1OWMxZTQyNDY2ZTAzYTM5OTk2ZmQ1YjkzNDFjMDhmNzMy Bethesda, MD 20894, Web Policies When evaluating any diagnostic test, commonly used parameters are its sensitivity and specificity. Moore KL, Dalley AF, Agur AMR. Sensitivity and specificity of a test. Varus stress test video provided by Clinically Relevant, Additional tests for detecting LCL injury with other knee ligaments:[6], Get Top Tips Tuesday and The Latest Physiopedia updates, The content on or accessible through Physiopedia is for informational purposes only. The agreed quality for each paper is included in Table Table33. Acute injuries excluded. The lower the LR, the more certain you can be that a negative test indicates the person does not have the disorder11 (Table (Table6).6). Described a modified version (Medial-Lateral Grind test) but no description of McMurray's. The Valgus Test of the knee is performed with the patient lies in the supine position. The preliminary nature of this tool also means that a more narrative review of the validity and accuracy of the tests has been presented. Based on chronicity of the injuries, MRI was more accurate for detecting acute FCL injuries than chronic injuries (P = .002), and varus stress radiographs were more accurate for detecting chronic FCL injuries than acute injuries (P = .041). The therapist applies a valgus stress at the knee while the ankle is stabilized in slight lateral rotation either with the hand or with the leg held between the examiners arm and trunk. These authors demonstrated marginally better LR+ but most interestingly, reported that their modified test (the KKU test) was 100% sensitive for lateral meniscal tears indicating that the test can be used for excluding a condition when it is negative. [5] The LCL further splits the biceps femoris into two parts. ODYyNmRjODBkYjVlYTFhN2Q3ZjEzNDRkNGI0OGNkZjQyNzhlZWM2MDE1MmQ1 Based on the STARD scoring of each paper, it is possible to make a qualitative assessment about the methodological quality. The inclusion of patients with different pathologies would make the results of studies more generalizable to the clinical setting. 2019 Jan 21;8(2):e141-e145. Generally, the McMurray's test has relatively high specificity and low sensitivity. Jaeschke RZ, Meade MO, Guyatt GH, Keenan SP, Cook DJ. In this position the iliotibial band relaxes and makes the LCL easier to isolate. National Library of Medicine Results: These authors considered the overall accuracy of the axially loaded pivot shift test to be higher than that of the McMurray's test (Table (Table7).7). Once again, this affects the generalizability of the findings. Valgus Stress Test Of The Knee 2023 | OrthoFixar Review bias may result when the findings of the reference standard test are known by the clinicians performing the diagnostic test. Copyright 2018 Arthroscopy Association of North America. . Clinical diagnosis of meniscal tears: Description of a new manipulative test. Some of the studies did not separate the data for medial from that of lateral meniscal testing5,6,22,25. Statistical evaluation of McMurray's test in the clinical diagnosis of meniscus injuries. N2IwYjAxYmE3NzM4ZmE2MTE5MTMyY2Q0M2I3NTQ5YjlkMzU3ODI3ODIyNzg0 Although these authors mentioned that the examiners were blinded to the results of the MRI, they did not make it clear if the examiners knew that there were a similar number of normals and symptomatic subjects included in the study or if they knew which group each individual subject belonged to. NjZjMWViMWE5MzNlMDFhOTA3YzAwYzUzODYzZmQyZGI2ODk1ZmJlOGM4YzZh Three studies in this review compared the McMurray's test to modified versions that incorporated the added components of varus/valgus stress and axial compression. An LR+ indicates the degree of certainty that a patient with a positive test actually has the suspected condition while an LR indicates the degree of certainty that a patient with a negative test does not have the suspected condition27. Eleven studies met the inclusion criteria. 2018 Aug;46(10):2355-2365. doi: 10.1177/0363546518784301. Test Position: Supine. J Sport Rehabil. Diagnosis of acute knee ligament injuries: The value of stress radiography compared with clinical examination, stability, under anesthesia and arthroscopic or operative findings. Knowledge of the diagnosis could influence the interpretation of the findings of the diagnostic test leading to an overstated diagnostic accuracy3. Valgus and Varus Stress Test - Physical Therapy Haven Thus, to avoid selection bias, it is important that a study include consecutive patients with pathologies that could be commonly confused with a meniscal tear and should not include patients without symptoms. Biomechanics of musculoskeletal injury. If the varus stress test is positive at 20, but negative at 0, only the LCL is torn. Fibular Collateral Ligament Reconstruction in Adolescent Patients. The differences in study populations are likely to have contributed to the wide variability of results across studies. No valgus or varus stress is applied. However, in general, the CI limits are relatively narrow over all. These authors suggested that this increase in sensitivity and specificity compared to previous studies was due to their broader definition of a positive test, i.e., reproduction of a click or pain3; however, this does not explain the similar findings of Corea et al4 in which only a click was indicative of a positive test. Three of the studies in this review considered a positive test to be the reproduction of a palpable thud or click4,6,22 (Table (Table4).4). Varus Stress Test [1] Magee DJ. Epub 2017 Aug 16. While it is difficult to compare results across studies due to the differences in the tests being used, the results of this review appear to show that the modified tests have higher diagnostic value than the McMurray's test. This an indication of a LCL tear. Take the leg and bring it in 30 Flexion (MLPP) and use a cushion or edge of the bed so the patient can relax. Pg 791. Powell JW, Huijbregts PA. Concurrent criterion-related validity of acromioclavicular joint physical examination tests: A systematic review. McMurray clearly indicated that the test that bears his name is only relevant for tears in the posterior portion of the cartilage (McMurray, 1942, cited in Corea et al4). M2ZmZDZjMzRlNTA5MjMyYzZkMGVlMDJkNzM3ODllMjM3ODFmYWJhZjAwYzZh This means that tests rarely have both high sensitivity and specificity. The findings of studies testing the validity of the McMurray's test have varied widely, mostly due to variations in the size and type of the study population as well as differences in description and application of the test3. The four possible outcomes include true positive, a false positive, a false negative, and a true negative (see Table Table2).2). Kane PW, Cinque ME, Moatshe G, Chahla J, DePhillipo NN, Provencher MT, LaPrade RF. 2017 Mar;101(Suppl 1):23-35. doi: 10.1007/s12306-017-0460-5. Another Systematic review study by Braun Schwieterman found that the sensitivity and specificity of the medial talar tilt stress test was 50% and 88 % respectively. Knee injuries. Flow diagram of literature screening process. Ocassionally, the LCL is congenitally absent. Limiting the search to English language articles only may also have led to an omission of other relevant studies. Increased Accuracy of Varus Stress Radiographs Versus Magnetic - PubMed Further, subjects who are positive on the reference standard should reflect a continuum of severity, whereas those who are negative should have conditions commonly confused with meniscal tears17. 2006;20:8594. MRI has also shown to be highly reliable, but due to its expensive cost, they are less frequently used. Patients identified as needing arthroscopy excluding those with intra-articular fracture, neurological or degenerative disorders. ZDM4MDExNDhjN2VjY2ExMjE4ZTQxZWUwYTUzMGUzZDcwYWYzMDA5YTYwODZh Sensitivity: 25% . The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes. (2007)Physical examination tests for assessing a torn meniscus in the knee: a systematic review with meta-analysis. Because they were investigating this weight-bearing test as well, the authors excluded any patients who presented within six weeks of trauma and those unable to bear weight or unable to squat. Y2RkNzAxODk3NTIxMTE2ZTkyYzE2ZjgxNmFmNWUxZGMwNmY4Mjg1ZDQ3MTkw Sensitivity & Specificity Sensitivity: 66 % Specificity: 60 % A study on 21 patients referred with chronic medial collateral ligament injuries, the Valgus stress test at 30, 60, 70, or 90 degrees of elbow flexion was performed (The Reference Standard was Surgical visualization ). Bookshelf Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). A recent systematic review reported a diagnostic accuracy between 56 - 84% 5.A prospective cohort study of 213 patients found poor sensitivity for medial and lateral meniscus tears of 48% and 65% respectively 6.Conversely specificity for medial and lateral meniscal tears was high, 94% . A guide to the interpretation of likelihood ratio (LR) values. Disclaimer. Other studies3,5,19 commented that greater clinical experience may affect the results of the test but they did not provide any statistical evidence to support this assertion. This study evaluated not only the McMurray's test but also a new test (Ege's test) for meniscal pathology that is performed in a weight-bearing position. The purpose of this paper was to assess the literature investigating the validity and diagnostic accuracy of the McMurray's test (and modifications) for determining meniscal pathology of the knee so that conclusions could be drawn regarding its clinical usefulness as a test. [12] If the varus stress test is positive at 20, but negative at 0, only the LCL is torn. McMurrays Test - Physiopedia MWU3NjBlM2FlMDU2YWM3ODA4ZGIyZTNjODFkOWU2ZDBkMGNiYzRhZjE2MGRk Clinical Rehabilitation, 22(2), 143-61. MGY4MmExODg4MDUwZTk2NzUzNjQ0OTMxYjkxN2QwYjQ5MmMxODdmMWU4MDdi document.getElementById( "ak_js_2" ).setAttribute( "value", ( new Date() ).getTime() ); We use cookies to optimize our website and our service. Your access to this site was blocked by Wordfence, a security provider, who protects sites from malicious activity. Clinically, we do not know whether a patient has the condition before the diagnostic test (arthroscopy or MRI) is performed. Studies that have evaluated the sensitivity and specificity of individual clinical tests to detect ligamentous injury, . Evans et al23 demonstrated a low level of agreement between the two examiners with intertester agreements ranging from poor for reproduction of a medial sensation (Kappa = 0.10) to fair (K = +0.38) for lateral pain. YzFjZGMyZmVmOTJjNWQ2NWYyNDVkNDE1OWM3Yzg5NjE2MWNhYTY1ZGZlNGYw The IR of the tibia followed by extension, the examiner can test the entire posterior horn to the middle segment of the meniscus. Sackett D, Richardson S, Rosenberg W, Haynes RB. An official website of the United States government. 2008 Saunders. Clipboard, Search History, and several other advanced features are temporarily unavailable. There is conflicting evidence with respect to the effect of the presence of an associated anterior cruciate ligament (ACL) deficiency. 1173185. Likelihood ratios overcome some of the problems involved with sensitivity and specificity values by summarizing the information contained in these values in a manner that can be used to quantify shifts in probability once the meniscal test results are known28. In: DeLee & Drez's Orthopaedic Sports Medicine. Baker PE, Peckham AC, Pupparo F, Sanborn JC. any of these symptoms can indicate a compromised medial or lateral meniscus. Differences in the type of tear have been suggested as influencing the result of clinical tests; however, no detailed investigation of this issue exists in the current literature3. MR imaging of meniscal cysts: incidence, location, and clinical significance. If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. The Journal of Manual & Manipulative Therapy. 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. Six of the studies within this review included consecutive patients (Table (Table4).4). Study with Quizlet and memorize flashcards containing terms like Ballottement, Valgus Stress Test, Varus Stress Test and more. Varus stress testing was performed in 20 of flexion, and testing in extension was not done. Painful conditions of the knee, inPain Management Vol 1.,2007. 2022 Jun 6;10(6):23259671221100216. doi: 10.1177/23259671221100216. FOIA McMurray test | Radiology Reference Article | Radiopaedia.org Federal government websites often end in .gov or .mil. Top Contributors - Rachael Lowe, Admin, Adrian Shaji, Kim Jackson, Evan Thomas, Amanda Ager, Kai A. Sigel, Wanda van Niekerk, Tony Lowe, Tyler Shultz and WikiSysop, Meniscus tears are the most common injury of the knee. As a stand-alone test, it had a sensitivity of 78% and specificity of 67% the pain was used as the outcome measure and a sensitivity of 91% and specificity of 49% when laxity was the outcome measure. Conclusions: Enroll in our online course: http://bit.ly/PTMSK DOWNLOAD OUR APP: iPhone/iPad: https://goo.gl/eUuF7w Android: https://goo.gl/3NKzJX GET OUR ASSESSMENT B. Evans et al23 used consecutive patients on a waiting list for arthroscopy for a variety of conditions including, but not limited to, suspected meniscal tears. How to Perform Varus Stress Test Position of Patient: The patient should be relaxed in the supine position. Address all correspondence and requests for reprints to: Wayne Hing. The studies that compared the diagnostic accuracy of the McMurray's test with that of modified versions of the test showed enhanced diagnostic accuracy for the modified tests. They commented that the lack of intertester agreement may have been due to differences in the amount of force produced. Diagnosis and treatment strategies of the multiligament injured knee: a Schulzer M. Diagnostic tests: A statistical review. Moreover, the ACL stabilizes the knee's rotation under varus or valgus stress. 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. In testing the accuracy of a clinical test like the McMurray's test, ideally the study participants should consist of individuals who would be likely to undergo the test in clinical practice and who have a reasonable chance of having the condition16. Whiting WC, Zernicke RF. [11] Sensitivity: 25% . National Library of Medicine Articles may have been missed based on the omission of certain search phrases or the use of a single search phrase as used in this case. Houten: Bohn Stafleu Van Loghum, 2005. An example of this would be as follows: If the McMurray's test had a LR+ of 9.2 for a particular study, a positive McMurray's test is 9.2 times more likely to occur in patients with a meniscal tear than in those without one29. H Nalwad; M Agarwal; B N Muddu; M Smith; and Mr. J K Borill (2006). ZmFjMDhjZmYyOWRiNWU2YjhhMWNhYjFiNTU5YTI5ODM3MTY1ODYwYzc2NmFi NCI CPTC Antibody Characterization Program. A recent study by Akseki et al3 reported high combined sensitivity and specificity figures (63% and 83%, respectively) and relatively narrow confidence intervals (Table (Table5).5). Partial Controlled Early Postoperative Weightbearing Versus Nonweightbearing After Reconstruction of the Fibular (Lateral) Collateral Ligament: A Randomized Controlled Trial and Equivalence Analysis. sharing sensitive information, make sure youre on a federal Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you. https://www.physio-pedia.com/index.php?title=Lateral_Collateral_Ligament_of_the_Knee&oldid=221054, A direct blow to the anteromedial knee and posterolateral corner, 0: Posteriolateral capsule, arcuate-popliteus complex, anterior and posterior cruciate ligaments, lateral gastrocnemius, 20-30: Posteriolateral capsule, arcuate-popliteus complex, iliotibial band, biceps femoris tendon. Studies investigating the validity of diagnostic tests such as the McMurray's compare the findings of that test with a reference (gold) standard that has demonstrated validity11. Four studies demonstrated that a positive test alters the probability to only a small, rarely important degree5,6,25, suggesting uncertainty that a positive test will indicate meniscal pathology (Table (Table5).5). Sensitivity figures vary from 16%88%, while specificity figures vary from 20%98% (Table (Table5).5). Clinial oriented anatomy. The sensitivity of a test reflects the proportion of people with the disease in question who are tested positive, whereas the specificity is the proportion of those without the disease who are tested negative. MDU1NWE1Nzc5OGVjNTczOGU2OWUyMWYxYmY3Njk5ZTdlMDEwZTQ3MTY0Zjdm Orthopedic Physical Assessment: 5 th Edition. During the maneuver, the joint line is palpated both medially and laterally. Varus Test | Special Tests The predictive value of Thve clinical signs in the evaluation of meniscal pathology. Treadmill stress tests should not be part of "routine health check Sensitivity and specificity values fail to do this11. The description of a test within a study should be sufficient to enable replication of the test by practitioners and subsequent researchers. Churchill Livingstone, 2002. A recent study by Winters and Tregonning13 showed a diagnostic accuracy for MRI to be 90% for the medial meniscus and 82% for the lateral meniscus. As is true of all statistics, sensitivity and specificity values are taken from a sample and represent an estimate of the true value that could be found in the population. eyJtZXNzYWdlIjoiMDAzMWIwNTU1ZDk0ZjIzMGU1NDkwYzhmOWYxZTk0YWI3 Inclusion in an NLM database does not imply endorsement of, or agreement with, The .gov means its official. MTk2NGZhNDE4OTk1NmViZWEyZWM3NzcwNDY0NzA4Y2VmMzBjNjI3MjUwNzdj Studies were included for analysis if they compared the McMurray's test with a gold standard of knee arthroscopy or magnetic resonance imaging (MRI). = (Number of TP + Number of TN)/(Numbers of TP + FP + FN), Identifies article as a study of diagnostic accuracy, Describes study population (inclusion criteria, exclusion criteria, settings, locations), Describes data collection (prospective or respective), Describes reference standard and rationale, Describes technical Specifications of material and methods involved, Describes definition and rationale of units, cut-of points, or categories of results of tests, Describes number, training, and expertise of raters. 2017 Dec;33(12):2177-2181. doi: 10.1016/j.arthro.2017.06.028. The sensitivity was 87% for the medial meniscus but only 46% for the lateral meniscus13. Careers. [4] The popliteus tendon is deep to the LCL, seperating it from the lateral meniscus. Original description. Consecutive patients scheduled for menisectomy; acute and chronic. doi: 10.1016/j.eats.2018.10.007. The examiner should passively bend the affected leg to about 30 degrees of flexion. Varus stress radiographs were determined to be more sensitive in diagnosing FCL injuries compared with MRI, with an overall sensitivity of 70% compared with 66%, respectively. Changing the threshold to increase sensitivity decreases specificity and vice versa. The results support the use of both varus stress radiographs and MRI in diagnosing FCL injuries, because MRI is more sensitive in diagnosing an acute FCL tear, and varus stress radiographs are more sensitive in diagnosing a chronic FCL tear. YzQ2ZWY3MDkyMmRjMWVjYzY3ODhjNTExZjU4NGIzMTJjNjA3ZDA5Mzk3NTFl The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network. Valgus Stress Test [1]. 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. The importance of the valgus stress test in the diagnosis of - PubMed [1] Medial meniscus tears are generally seen more frequently than tears of the lateral meniscus, with a ratio of approximately 2:1. In most cases Physiopedia articles are a secondary source and so should not be used as references. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). ODA1ZGIwMjcwNDYzZDc3OTkwMWYwNWVkMWRlYzk1ZWExOTVhNjBiNWQ2MzUw -----BEGIN REPORT----- Anderson and Lipscomb5 compared the McMurray's test to a test termed the Medial-Lateral Grind test that included a varus/valgus component not included in the original McMurray's test. They rated the sensitivity at 25% and could not report any specificity percentage. There are several different reported methods of performing McMurrays Test, Reiders method may be the most accurate[9], Get Top Tips Tuesday and The Latest Physiopedia updates, The content on or accessible through Physiopedia is for informational purposes only. Similarly, sensitivity figures ranged from 27% to 70% across the reviewed papers, generally indicating that a torn meniscus is likely to be missed in many patients; however, specificity figures (2996%) indicating that false positive tests are relatively low and that a positive test makes it likely that the patient actually does have a torn meniscus. Higher specificity figures denote that in general when the McMurray's test is positive, it is fairly reliable for ruling in meniscal pathology. Effect of Sectioning of the Anterior Cruciate Ligament and Posterolateral Structures on Lateral Compartment Gapping: A Randomized Biomechanical Study. 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. Varus stress testing was performed in 20 of flexion, and testing in extension was not done. Yedlinsky, N.T. Varus Stress Test - The Student Physical Therapist
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