Knee Exam

Question 1

How does a valgus deformity of the knee present?

Answer 1

The tibia is turned outward in relation of the femur, leading to ‘knee knocking;

Question 2

How does a varus deformity of the knee present?

Answer 2

The tibia is turned inward in relation to the femur, resulting in bowlegged appearance

Question 3

What may tenderness of the patella indicate?

Answer 3

Injury or patellofemoral arthritis

Question 4

What may tenderness of the patellar ligament indicate?

Answer 4

Tendonitis or rupture

Question 5

What may tenderness of the medial and lateral joint lines indicate?

Answer 5

• Fracture
• Meniscal injury e.g. meniscal tear
• Collateral ligament injury e.g. rupture

Question 6

What may cause joint effusion?

Answer 6

• Ligament rupture e.g. ACL
• Septic arthritis
• Inflammatory arthritis
• Osteoarthritis

Question 7

What is the patellar tap test used for?

Answer 7

Used to screen for the presence of a moderate-to-large knee joint effusion

Question 8

What is the sweep test used for?

Answer 8

To identify small joint effusions that may not be obvious using the patellar tap

Question 9

Why do you palpate the patellar ligament?

Answer 9

For tenderness suggestive of tendonitis or rupture

Question 10

What may a pulsatile mass in the popliteal fossa indicate?

Answer 10

A popliteal aneurysm

Question 11

What is the normal range of movement for active knee flexion?

Answer 11

0 - 140 degrees

Question 12

How do you get a patient to do an active knee flexion?

Answer 12

‘Move your heel as close to your bottom as you can’

Question 13

What is the normal range of movement for active knee extension?

Answer 13

Should be able to lie flat (180 degrees)

Question 14

How do you get a patient to do an active knee extension?

Answer 14

‘Straighten your leg out that it is flat on the bed’

Question 15

What is the normal range of movement for passive knee flexion?

Answer 15

0 - 140 degrees

Question 16

What does excessive knee hyperextension indicate in passive knee extension?

Answer 16

Pathology affecting the integrity of the knee joint’s ligaments

Question 17

What is the posterior sag sign?

Answer 17

When the tibia sags posteriorly in relation to the femur, as a result of PCL rupture

Question 18

What is the anterior drawer test used for?

Answer 18

To assess the integrity of the anterior cruciate ligament

Question 19

What are the results of the anterior drawer test?

Answer 19

• Significant movement

- May indicate anterior cruciate ligament laxity or rupture

Question 20

What is the posterior drawer test used for?

Answer 20

To assess the integrity of the posterior cruciate ligament

Question 21

What are the results of the posterior drawer test?

Answer 21

• Significant movement

- May indicate posterior cruciate ligament laxity or rupture

Question 22

What is Lachman’s test used for?

Answer 22

Laxity or rupture of the ACL

Question 23

What are the results of the Lachman’s test?

Answer 23

Significant anterior movement of the tibia on the femur suggests ACL laxity or rupture

Question 24

What is the purpose of the lateral collateral ligament assessment (varus stress test)?

Answer 24

To assess the integrity of the LCL of the knee joint

Question 25

What is the purpose of the medial collateral ligament assessment (valgus stress test)?

Answer 25

To assess the integrity of the MCL of the knee joint

Question 26

What is McMurray’s test used to assess?

Answer 26

To assess the menisci for evidence of a meniscal tear

Question 27

What assessments and investigations should be completed after a knee examination?

Answer 27

• Neuro exam of lower limbs
• Examination of Ankle and hip
• Further imaging