Knee Exam

Question 1

Knock Knee Deformity

Answer 1

Valgus

Question 2

Bow leg deformity

Answer 2

Varus

Question 3

Knee hyperextension

Answer 3

Genu Recurvatum

Question 4

What does Lateral collateral ligament testing look for

Answer 4

Lateral gaping in a laterally unstable knee representative to the contralateral side.

Question 5

What does a positive anterior draw test suggest

Answer 5

ACL damage

Question 6

What does the posterior sag test suggest

Answer 6

PCL damage - step visible patellar

Question 7

Next steps to complete a Knee examination

Answer 7

Examine the Hip and Ankle
Lower limb neurological and vascular examination
Look for relevant imaging

Question 8

What does lachmans test for

Answer 8

ACL laxity

Question 9

What does McMurrays test for

Answer 9

Torn meniscus between femoral condyle and tibial plateau

Question 10

What does the patellar apprehension test for

Answer 10

Previous patellar dislocation or instability

Question 11

Common pathologies of the knee

Answer 11

ACL injury
OA
Dislocation
Patellar Tendinitis
Knee bursitis
Torn Meniscus
Iliotibial band syndrome - Runners knee

Question 12

Causes of knee pathology

Answer 12

Sepsis
Reactive arthritis
Trauma

Question 13

Presenting complaints knee

Answer 13

• Pain
• Restriction of movement
• Stiffness
• Swelling
• Redness
• Temperature

Question 14

Order of knee exam

Answer 14

• Inspection
• Standing
• Walking
• Balance
• Lay down on bed and assess movement, stability and palpation
• Special tests if applicable

Question 15

Inspection of knee

Answer 15

• Muscle wasting
• Joint position at rest - Varus/Valgus
• Swelling and its position
• Erythema or skin changes
• Comment on patients stance

Question 16

Feeling of knee

Answer 16

• Temperature
• Swelling - soft or hard, localised or generalised
• Palpate for any effusion using patellar tap or pillar test

Question 17

Movement of knee

Answer 17

• Get the patient to flex and extend the knee as far as possible
• Ask the patient to actively flex and extend his knee (normal range of flexion = 135°, normal range of extension = 0°).
• Assess passive movement by placing one hand on the patient’s knee and flexing the knee as far as possible with your other hand.
• Palpate for crepitus during passive flexion and extension.

Question 18

Specialist knee tests

Answer 18

Lateral collateral ligament test
Medial CLT
Anterior draw test
Posterior sag test
Lachmans
McMurrays
Patellar apprehension test

Question 19

Completion of knee examination

Answer 19

• Examine the ipsilateral hip and ankle. When examining the ankle, you should use the schema ‘look, feel, move’.
• Assess the neurological and vascular status of the limb (In the OSCE, unless you are given specific instructions to perform this assessment, you should simply state to the examiner that you would do so).
• Thank the patient and request them to redress
• Wash your hands

Question 20

When not to do a ACL test

Answer 20

When pt had previous dislocation