KNEE Flashcards
AROM
Flex: 0-135
Ext: 0 - (-15)
IR: 20-30
ER: 30-40
Jt Positioning
Resting position: 25° flexion
Close-packed position: Full ext, ER of tibia
Capsular pattern: Flexion, extension
END FEEL
Tissue Approximation
Flexion
Tissue Stretch
Extension
Medial rotation of tibia on femur
Lateral rotation of tibia on femur
Tissue stretch—all directions
Patellar movement
Valgus Stress Test
SUPINE: Leg resting on the table (0o). Cup the lateral side fingers at back on knee & hold prox to the ankle on ant tibia. Repeat with knee in 20-30 degrees knee flexion.
TESTING: Medial instability, MCL torn
+VE: Excessive gapping of medial joint line with pain
Varus Stress Test
SUPINE
Get client to move feet to end of table. Start w the leg resting on the table (0o). Cup lat ankle and inside of the knee. Repeat with knee in 20-30 degrees knee flexion.
TESTING: Lateral instability, LCL torn
+VE: Gapping or pain
Anterior Drawer Sign
SUPINE: Hip flexed to 45o, knee flexed to 90o. Examiner holds down onto just above the ankle & examiner draws tibia forward by holding onto the medial part and pulling towards you.
TESTING: (ACL) injury/tear
+VE: Movement of tibia more than 6 mm
Posterior Drawer Test
SUPINE: Hip flexed to 45, knee flexed to 90. Examiner holds down onto just above the ankle & Ex pushes tibia backward.
TESTING: (PCL) injury/tear
+VE: Movement of tibia more than 6 mm
Lachman Test
SUPINE: Client lies on their back with the hip flexed to 45o. The knee is flexed to 30o and slightly laterally rotated. The examiner stabilizes the femur with one hand while applying an anterior force to the tibia with the other hand
TESTING: (ACL) injury
+VE:
1. Pain
2. A “mushy” or soft end feel
3. Disappearance of patellar ligament slope
Brush/Wipe Test
SUPINE
Start inf patella then sweep up 3x, on the lat side down 1x
TESTING: Accumulation of knee fluid in the knee
+VE: A wave of fluid appears on the medial side of the knee, below the patella, within 2 seconds
Clarke’s Sign
Client lies on their back with the knee fully extended. Examiner places their hand just proximal to the patella and applies downward pressure. Client is then asked to contract their quadriceps while the examiner maintains pressure on the patella.
TESTING: Patellofemoral Dysfunction
+VE: Sharp pain under patella or inability to maintain quadriceps contraction
Apprehension Test
SUPINE: Client lies on their back with the knee flexed to 30° and quadriceps relaxed. Examiner pushes the patella laterally and medially, slowly and carefully
TESTING: Dislocation of the patella
+VE: Patient contracts quadriceps and shows an apprehensive look
McMurray Test
SUPINE – knee flexes
The client lies on their back with the knee fully flexed (heel to the buttock). The examiner medially rotates the tibia and extends the knee to test the lateral meniscus. To test the medial meniscus, the examiner laterally rotates the tibia and extends the knee. The test may be repeated through the full range of motion
TESTING: Meniscal pathology
+VE: A snap, click, or pain during tibial rotation and knee extension
Thessaly Test
STANDING
The patient stands flat-footed on one leg, holding the examiner’s hands for balance. The knee is flexed to 5° and rotated medially and laterally three times. Then, the test is repeated at 20° flexion.
TESTING: Meniscal pathology
+VE: Medial or lateral joint line discomfort, or a sense of locking or catching in the knee,
Noble Compression Test
SUPINE
The patient lies on their back with the knee flexed to 90° and the hip flexed. The examiner applies pressure with their thumb to the lateral femoral epicondyle. While maintaining pressure, the patient slowly extends the knee.
TESTING: ITB friction syndrome
+VE: Severe pain over the lateral femoral condyle at about 30° of knee flexion, mimicking pain experienced during activity
