Knee

Question 1

1

Answer 1

Wash your hands
• Introduction, identification and consent

NOTE:
Both knees and left hip can be examined
for hip:
look/inspect (potentially measure if tape measure is out)
feel - palpate around. ask if any pain
move - active flexion, abd and add. passive flexion, abd and add. passive internal and external rotaion
special test - thomas’ - hand is on both iliacs and stand on one leg

Question 2

2

Answer 2

INSPECT
With the patient standing, inspect from the 
-FRONT
-SIDE
-BEHIND

Then gait?? 

Question 3

3

Answer 3

Get them on the bed!

Position the patient supine on the couch with their hips and knees extended. INSPECT - hips and knees

o Symmetry
o Valgus and varus deformity
o Rashes e.g. psoriasis
o Scars
o Swelling
o Muscle wasting

Question 4

4

Answer 4

Palpate

-TEMP
using back of hand comparing both sides (go from high on thigh to just below knee)

Question 5

5

Answer 5

Palpate BORDERS
of patella for tenderness

and quad and patella tendon

so start above it feeling for quad tendon, then around it/borders, then patella tendon

Question 6

6

Answer 6

Palpate BEHIND

the knee for popliteal swellings or cysts

Question 7

7

Answer 7

The patellar tap -

squeeze down leg, tap patella 2 or 3 times with the middle finger

Question 8

8

Answer 8

Swipe test:
Swipe with back of one hand the fluid up the medial side of the knee and try hold it in the suprapatellar pouch (keep hand there) just above the knee. then with other hand swipe down from the top of it, downwards
should see buldge appear below where youve kept the hand

basically swipe up on under patella on one side, swipe down on the other

Question 9

9

Answer 9

FLEX to 90 and PALPATE

Flex the knee up to 90° to open the joint line. Palpate the joint line and patellar tendon, head of the fibula,

Question 10

10

Answer 10

MOVEMENTS:

Active knee flexion

get them to bring heel to bum when lying down… and straighten leg back out

Question 11

11

Answer 11

Passive knee flexion

have one hand on knee feeling for crepitus (MS) and one hand on ankle pushing it up

And passive knee hyper extension, lift ankle upwards

Question 12

12

Answer 12

Special tests: x4
Posterior sag test (PCL)

• Knee flexed to 90 degrees foot flat on the bed
• Inspect from side for ‘sag’

A posterior sag of the upper tibia, with a ‘step’ visible
below the patellar, is suggestive of posterior cruciate ligament (PCL) damage

Question 13

13

Answer 13

Anterior draw (ACL)

• Knee flexed to 90° and foot flat
• Stabilise the leg using your own forearm
• Fingers behind knee, thumbs on front of knee between joint line
• pull forward kinda quick

Significant movement indicates anterior cruciate ligament (ACL) damage

Question 14

14

Answer 14

Lateral ligament

• flex knee to 20 degrees
• one hand on back of heel
• push OUTWARDS
• repeat on other (look for asymmetrical gaping)