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Knee Exam

Knee Exam

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Positioning: Patient standing then supine

The Patient

Around the Room
Mobility devices, sling, brace, etc.
General Features
Age, gender, general comfort, scars

Look

Assistance Devices
Stick, brace, sling, cast
Skin
Rashes, scars, erythema
Swelling
Over muscles, bones or joints
Bursae
Supra-, infra-, pre-patellar bursae, Baker's cyst
Muscles
Wasting, spasm, fasciculations
Deformities
Genu valgum, genu varum, genu recurvatum
Posture
Standing, sitting, squatting
Body position, centre of gravity
Gait
Posture, symmetry, rhythm, coordination, stride
Leg Length
True (ASIS → medial malleolus) and apparent

Feel

Temperature
Palpate with the back of the hand
Bony Landmarks
Femoral (epi)condyles, fibular head, patella, tibia
Muscles
Muscle bulk, tenderness, wasting, spasm
Joint Line
Tenderness, fullness
Ligaments
Medial & lateral collateral ligaments
Tendons
Biceps, semimembranosus, semitendinosus
Sounds on Knee Movement
Clicks, cracks, snaps, clunks
Pulses
Popliteal

Move

Active → Passive
Ask before stressing painful joints
Flexion
Closing the joint
130°
Extension
Opening the joint
5°
Internal Rotation
Rotate foot inwardly
10°
External Rotation
Rotate foot outwardly
20°

Special Tests - Patella

Patellar Tap
Sharply press the patella with 2-3 fingers
Bulge Test
Stroke hand medial, up & around to lateral patella
Patellar Apprehension
Apply laterally directed force on medial patella

Special Tests - Menisci

McMurray's Test - Medial
For medial menisceal tears
Supine, hip & knee flexed 45° - externally rotate foot and apply valgus force while extending knee
McMurray's Test
For lateral menisceal tears
Supine, hip & knee flexed 45° - internally rotate foot and apply varus force while extending knee

Special Tests - Ligaments

Anterior Draw Test
90°, stabilise foot, stabilise tibia, pull anteriorly
Posterior Draw Test
90°, stabilise foot, stabilise tibia, push posteriorly
Valgus Stress Test
Brace lateral knee at 30°, apply valgus force
Varus Stress Test
Brace medial knee at 30°, apply varus force

Ligaments of the Knee

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Overview

The medial and lateral collateral ligaments may be palpated on either side of the knee joint.
The anterior and posterior cruciate ligaments lie within the knee joint and therefore may not be palpated.

Last updated on January 1st, 2017

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Read More...

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