Knee Evaluation Flashcards
1
Q
Pathology based on location of pain
A
- Anterior knee pain w/jumping and/or full knee flexion = patellar tendonitis or patellofemoral pain syndrome
- Anterior knee pain w/prolonged knee flexion, squats, and stair climbing = patellofemoral pain syndrome
2
Q
Self assessments for the knee
A
- Lower extremity functional scale (LEFS)
- The western Ontario and McMaster universities osteoarthritis index (WOMAC)
3
Q
Functional screen for the knee
A
- single leg stance
- squat
4
Q
Neuromuscular testing for the knee
A
- SLR
- femoral nerve stretch
- dermatomes/myotomes
- consider reflexes
5
Q
Anterior glide of tibia on femur
A
- helps knee extension
- performed prone in about 20 degree of flexion
6
Q
Posterior glide of tibia on femur
A
- helps knee flexion
- preformed in sitting with slight flexion
7
Q
Rotation of tibia on femur
A
- no mobilize if there is crepitus, always apply distraction
- ER helps knee extension
- performed in sitting with slight flexion
8
Q
Distraction of the tibiofemoral joint
A
- performed in prone with knee bent to 90 degrees
- pull through ankle towards the ceiling
9
Q
Special tests for knee effusion
A
- Ballottement test: patient supine, push patella posterior w/2-3 fingers
- Positive = patella bounces off trochlea + self noticed knee swelling
10
Q
Special tests for quadriceps Q-angle
A
- patient supine and knee extended but not hyperextended
- align one arm of goniometer with ASIS and other arm with tibial tubercle with the fulcrum at the patella
-Normative value = 13.5 degrees into valgus +/- 4.5 degrees
11
Q
Special tests for ACL
A
- Lachman test: pt supine w/knee flexed b/w 10-20 degrees & pull tibia forward
- Anterior drawer: pt supine with knee flexed b/w 60-90 degree & foot on table then pull tibia anteriorly
- Pivot shift test: pt supine, lift pt’s heel to flex hip to 45 degree and place knee in 10-20 degrees of flexion, perform forceful IR of tibia and fibula while reading valgus force, Pos. = tibial plateau subluxes anteriorly
- Lever sign: pt supine with small towel roll under the knee just distal to femur and push on distal femur, Pos. = leg does not lift off of the table
- Loss of extension test: pt supine, passively extend the knee and measure distance from heel to plinth, Pos. = decrease extension ROM compared to unaffected knee
12
Q
Special tests for PCL
A
- Posterior draw test: pt supine with knee bent and foot on table, push posteriorly on the tibia
13
Q
Special tests for collateral ligaments
A
- Varus and Valgus tests: pt supine with knee flexed 20 degrees, apply varus/valgus force at joint line
- Positive = pain or laxity
14
Q
Special tests for meniscus
A
- McMurry: pt supine, bring knee into 90 degrees flexion while maintaining IR of tibia & then repeat while maintaining ER of tibia, Pos. = click or pain
- Apply Grind test: pt prone with knee flexed to 90 degrees, push through heel towards table while IR and ER tibia, Pos. = pain
- Thessaly test: pt standing on one leg with slight knee bent, rotate patient internally with knee bent at 5 degrees and then 20 degrees, Pos. = pain and/or click in the knee
15
Q
Combination of special tests for meniscus tear
A
- age >40, continuation of activity impossible, WBing during trauma, and pain w/passive knee flexion
- tenderness on joint line palpation and McMurray test
- tenderness on joint line palpation and Thessaly test
