Examination of the knee

Question 1

Start by introducing yourself and confirming the name and age of the patient

Answer 1

“Hi I’m Sarah, one of the doctors here today. Are you able to confirm your name and age for me please?”

Question 2

Explain the examination in brief and get consent

Answer 2

“I’ve been asked to examine your knee today. This will involve looking, feeling and moving the joints in your legs. I will be discussing my findings out loud to the examiner. Will that be okay for you?”

Question 3

Before beginning, check to see whether the patient has any pain

Answer 3

“Is there any part of your body that you are sore?”

Question 4

Start by looking. What does this involve?

Answer 4

Ask the patient to walk, observe their gate.

• Do their knees move freely?
• Do they have an antalgic gait?

Observe the patient standing from front, side, behind. Also observe lying down 
Comment on:
- Varus and values deformities
- Flexion/ extension contractors
- Obvious swellings/ deformities
- Skin changes/ skin colour
- Wounds/ lacerations

Question 5

Next, feel the legs. What does this involve?

Answer 5

Feel for warmth of the leg.
Feel for joint effusions (patellar apprehension test, patella sweep test)
Feel along the joint line
Feel for crepitus

Question 6

Next, move the legs. What does this involve?

Answer 6

Ask the patient to actively flex and extend their legs. Comment on the range of motion.
Passively flex and extend the legs.
Check the stability of ligaments
- Apply varus and valgous forces to the knee.
- Anterior draw test and Lachman’s test
- Posterior sag test

Question 7

Check the neuromuscular status of the knee.

Answer 7

Check the sensation of the knee to light touch.
Check the power of the limb.
Check the pulses: DT, PT, Popliteal, Femoral.
Check the capillary refill.