Knee

Question 1

what are you looking for in a knee examination when the patient is standing

Answer 1

limb alignment
valgus (knock knee) or varus (bow knee) deformity
quadriceps and hamstring muscle mass
popliteal fossa (bursa and baker’s cyst)

Question 2

what are you looking for in the patients gait during a knee examination

Answer 2

pace
symmetry
gross gait abnormalities - antalgic gait
walking aids

Question 3

what are you looking for in a knee examination when the patient is lying on couch

Answer 3

erythema
skin changes
bruising
scars
hair changes
swelling - generalised, joint effusion, bursa

Question 4

when doing the feel section in a knee examination what position should the knee be in

Answer 4

flexion

Question 5

what are the 7 things to feel in a knee exam

Answer 5

temperature
tibial tuberosity
patella tendon
medial and lateral joint lines
medial and lateral collateral ligaments
popliteal fossa
bursae - popliteal, suprapatellar, prepatellar

Question 6

what are the movements involved in the knee examination

Answer 6

flexion - feel for crepitus when flexing
extension

Question 7

what are the 7 special tests in a knee examniation

Answer 7

straight leg raise
medial gutter sweep test
Steinmann’s test
collateral ligaments test
cruciate ligament tests
patellar grind test
patellar apprehension test

Question 8

what does the straight leg raise test for

Answer 8

confirms intact extensor mechanism

Question 9

what does the medial gutter sweep test look for and explain the test

Answer 9

small effusion
sweep the effusion out of one side of the knee and then hold it while sweeping once downwards on the other side
observe to see if the effusion flows back to the other side

Question 10

describe Steinman’s test

Answer 10

with the knee in flexed position place your thumb in the joint line and turn the leg to the opposite side observe if it causes pain in the knee
repeat on the other side of the joint

Question 11

what does steinman’s test look for

Answer 11

meniscal tear

Question 12

describe the collateral ligament test

Answer 12

with the knee in extended position hold the knee and move the leg laterally and then medially

Question 13

what are the cruciate ligament tests

Answer 13

Lachman’s test
anterior drawer test
posterior drawer test

Question 14

describe Lachman’s test

Answer 14

holding the knee in one hand and the leg in the other hand pull the leg towards you and push the knee backwards

Question 15

describe anterior and posterior drawer test

Answer 15

with the knee in flexed position, sit on the patient’s foot if possible and take the leg in both hands with the thumbs over the tibia
anterior drawer - pull the leg towards you
posterior drawer - push the tibia backwards

Question 16

describe patellar grind test

Answer 16

mobilise the patella and observe if it causes the patient pain

Question 17

describe the patellar apprehension test

Answer 17

push the patella to one side and observe if it causes the patient to have apprehension and pain