Knee Flashcards
Ballotment Test
For: effusion in knee joint
How: supine, push palm downward on patella
+ = end feel soft and boggy
- = end feel hard
Fluctuation Test
Tests: Edema/effusion in knee joint
How: supine. fingers medial and lateral, web on superior patella, apply pressure
+ = fingers spreading apart, patella moving inferiorly
Tibiofemoral Posterior Glide
For: increase knee flexion
How: Supine, resting position ( flexion), stabilize femur from the posterior side, hand on proximal tibia, push posteriorly
Tibiofemoral Anterior Glide (3)
For: increasing knee extension
How:
1. Supine, resting position, sit on foot, both hand grip proximal tibia from posterior side, pull anteriorly
2. Supine, resting position, stabilize hand posterior proximal tibia, apply posterior pressure on distal femur ( femur moving posteriorly to tibia is same as tibia moving anteriorly on femur)
3. Prone, resting position, stabilize distal femur from anterior side, apply pressure on proximal tibia on posterior side.
Tibiofemoral Medial Glide
For: examine
How: Supine, resting position, sit between legs, stabilize distal femur on medial side, entire arm on fib/tib and hand at proximal tibia laterally apply pressure medially
Tibiofemoral Lateral Glide
For: examine
How: Supine, resting position, sit next to pt, stabilize distal femur laterally, grip tibia with hand and forearm and move laterally.
Tibiofemoral Medial Gap
For: examine, dec pain
How: Supine, resting position, stand next to pt, stabilize distal lower leg (ankle) with lower leg against body, push medially on lateral side of knee at jt line.
Tibiofemoral Lateral Gap
For: examine, dec pain, incr ROM
How: Supine, resting position, sit between legs, stabilize distal lower leg (ankle) laterally, push laterally at medial joint line
Apley’s Distraction Test
Tests: ligamentous laxity (problem)
How: prone, stabilize femur with knee flexed then distract and rotate
+ = pain
Valgus Stress Test
Tests: Ligamentous strain of MCL
How: Supine, knee at 30 degrees of flexion push into valgus (medial gap). repeat at full extensions
+ = pain or increased excursion
grade 1 = pain no increased excursion
grade 2 = pain, increased excursion
grade 3 = very little pain, a lot of increased excusion
Varus Stress Test
Tests: Ligamentous strain, LCL
How: Supine, knee at 30 flexion, push knee into varus (push laterally from medial side - Lateral gap) repeat with extended knee
+ = pain or increased excursion
grade 1 = pain, no increase excursion
grade 2 = pain and increased excursion
grade 3 = very little pain, a lot of increased excursion
Anterior Draw Test
Tests: Ligamentous, ACL
How: supine, knees flexed to 90. pull tibia anteriorly with palpating jt space
+ = pain or increased excursion
grade 1,2,3
Lachman’s Test
Tests: ACL - superior to anterior draw
How: Supine, knee 20-30 flexion pull tibia anteriorly with palpating tbiofemroal jt space creating counter pressure on femoral condyles
+ = pain or increased excursion
grade 1,2,3
Slocum’s Test:
Tests: ligaments, ACL
How: Supine, knee flexed to 90, IR lower leg, pull proximal tib anteriorly. Medial plateau should move more
+ = pain or increased excursion
grade 1,2,3
Lateral Pivot Shift Test
Tests: ligament sprain, ACL - ALRI
How: supine, knee extended, IR lower leg and push knee into valgus, then flex knee maintaining IR and medial pressure
+ = lower leg will ER against me
Posterior Draw Test
Tests: ligament sprain, PCL
How: Supine, knee flex to 90. Stabilize lower leg, push posterior on distal femur
+ = pain or increased excursion
grade 1,2,3
Posterior Sag Sign
Tests: Ligament sprain, PCL
How: Supine, bilateral 90/90, looking at anterior superior aspect of tibia on femur, comparing
+ = tibia on affect side is posterior in comparison to unaffected tibia
DO THIS BEFORE ANTERIOR DRAW OR LACHMANS - could give false +
Anterior Reduction Test
Tests: Ligamentous laxity, PCL
How: supine, few degrees of flexion, tell pt to lift heel off table, look at anterior contour changes of tibiofemoral jt
+ = anterior aspect of tibiofemoral jt changes the affected doesn’t look like unaffected - presence of posterior sagging is eliminated
DO BEFORE ANTERIOR DRAW OR LACHMAN’S TESTS, PCL laxity can cause false +
McMurray’s Test
Tests: Medial Meniscus tear
How: Supine, flex hip and knee to end range, IR lower leg. then extend to 90 degrees maintaining IR. repeat with ER of lower leg.
+ = palpable thud or click
Apley Compression Test
Tests: Meniscal tear (both medial and lateral)
How: prone, knee flexed to 90, compress downward and rotate leg
+ = pain in knee
pain with IR/medial rotation = lateral meniscus tear
pain with ER/lateral rotation = medial meniscus tear
Thessaly Test
Tests: Meniscal tear
How: SLS on affected. rotate knee and body IR and ER three times at 5 degrees of flexion, the 20 degrees.
+ = pt reports locking or catching
Noble Compression Test
Tests: ITB irritation
How: supine, 90/90. apply pressure to lateral femoral condyle and tell pt to ext knee
+ = lateral lower thigh pain at 30 degrees of flexion
Hughston’s Plica Test
Tests: Plica
How: seated, knee flexed to 90, IR tibia. Push patella medially. extend and flex knee
+ = popping
Patellar Tendonopathy
(jumper’s knee)
anterior knee pain, increases with jumping and full extension
pain increases with isom knee ext and PROM knee flexion
-q angle, patella alta, leg length discrepancy, tight rectus femoris, tight hamstrings
TREATMENT - strengthen quads eccentrically
ITB syndrome
-tibial vara, genu varum, subtalar carus, subtalar valgus, pronation, leg length discrepancy, excessively prominent lateral femoral condyle, tight ITB
TREATMENT - STM, strength, strengthen
OA in knee
morning pain and stiffness (goes away within an hour - unlike RA)
exercise and weight reduction
acupunture, TENS, LASER
