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Knee Exam
 
 

Assessing Movement

 
 
 
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Active Movement

  • How to Assess

  • Ask the patient to move the joint themselves. Assess the neutral position and the range of motion, and ask whether range of motion is limited by pain, weakness or stiffness.
  • Significance

  • Active movement is an indicator of the patient's ability to move the joint. It may be limited due to weakness, pain, mechanical stiffness or poor compliance.
  • Causes of Limited Active Movement

  • Joint pain / stiffness - see below
  • Upper motor neuron lesion - stroke, tumour, trauma, hypoxia, demyelination, deposition, inflammation
  • Lower motor neuron lesion - trauma, compression, demyelination, neuromuscular disorders, diabetes
  • Poor compliance

Passive Movement

  • How to Assess

  • Move that patient's joint. Note the range of motion and whether it is limited by pain, swelling or stiffness. Note any crepitus.
  • Significance

  • Passive movement is a measure of the objective range of motion of the joint. It may be limited by stiffness of the joint, or active resistance on the patient's part.
  • Interpretation

  • Decreased Knee Range of Motion

  • Arthritis - rheumatoid, osteoarthritis, septic arthritis
  • Bursitis - prepatellar, infrapatellar, pes anserine, iliotibial
  • Tendonitis - patellar, biceps, semitendinosus, semimembranosus
  • Tear - meniscus, ligament
  • Loose intra-articular body
  • Patellar Crepitus

  • Chondromalacia
  • Patellar fracture
  • Snapping Knee Joint

  • Dislocation - tibio-fibular joint, patello-femoral joint
  • Discoid meniscus
  • Menisceal cyst
  • Snapping of tendons
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