Knee exam

Question 1

Go over the surface anatomy of the knee

Answer 1

Question 2

What do you inspect the knees for?

Answer 2

With patient standing

1)bony allignment

• valgus, varus or hyperextension deformity
• line drawn from iliac crest to middle toe

2)Swelling or masses

3)Gait

4)squatting and assessing patellofemoral compartment –> crepitus…

with patient sitting

1)patellar tracking

2)prominence of the tibial tuberosity

with patient lying

1)assymetry between knees

2)masses

3)Scars/ lesions

4)muscle atrophy and hypertrophy

Question 3

What do you palpate the knees for?

Answer 3

1)Temperature above and below the patella

2)Tenderness

• joint line
• collateral ligaments (MCL, LCL)
• patellar edges
• pre-patellar bursa and suprapatellar bursa
• pes anserine bursa

3)Crepitation

4)Effusion

bulge sign–>best for small effusions

–> milk medially and sweep down lateral

Ballotement–> best for large effusions

–> press down on suprapatellar pouch and then try to move fluid around

Patellar tap-

–> milk fluid into suprapatellar pouch and then press down of pattella –> listen for clunk

Question 4

How do you test active ROM

Answer 4

Patient displays on their own

Question 5

How do you test passive ROM on the knee?

Answer 5

Flexion

Extension

Isolation of that joint alone

look for crepitus

Question 6

How do you test the ligaments, meniscus and patella?

Answer 6

ligaments

1) MCL–> create valgus deformity
2) LCL–> create varus deformity
3) ACL –> anterior drawer test

–> lachmans test with knee fixed in 20-30 degrees of flexion

4)PCL–>posterior drawer test

meniscus’s

McMurrays test for medial meniscus–> fingers on medial joint line, valgus deformity ( ankle inward) + internal rotation

McMurrays test for lateral meniscus–> fingers on lateral joint line, varus deformity (ankly outward + external rotation)

Thessaly test