Knee Exam - PPT Flashcards
what is a common observation for those with osgood-schlatters? in what populations are these most commonly seen?
growth on tibial tuberosity
– children through puberty
– middle aged males
what is the modified stroke test for?
determining swelling types within the knee
how to perform the modified stroke test
move swelling upward from medial joint line toward suprapatellar pouch
move swelling downward from suprapatellar pouch to medial joint line
–> the swelling will press medially
general knee rom
flexion = 150
extension = 0
IR/ER = 45
how to measure rotation at the knee
inclinometer on tibia
rotate IR and ER from neutral for measurements
explain resisted strength portion of exam in suspected knee muscle power deficit
if HSI is suspected, level A evidence suggests:
quantify knee flexor strength via dynamometer
what is suggested if HSI is suspected in palpation portion of exam
length between injury and ischial tuberosity
– assists in predicting timing of return to play
open pack position for tibiofemoral jt
relative flexion
open pack position for patellofemoral joint
relative extension
when would fibular head mobilization be indicated
rotational deficits originating in the knee
– anteromedial and posterolaterally
at what angle is the most compression found in the patellofemoral joint
70 degrees flexion
explain how the patella moves in flexion/extension
extension - patella moves superiorly
flexion - patella moves inferiorly
how to measure length of HS
patient supine
hip flexed to 90
extend knee - take measure from terminal extension
what is the cluster for meniscal injury
tibiofemoral joint line pain
pain with forced hyperextension
pain with max knee PROM
(+) McMurray
explain a positive valgus stress test
- any possible next steps
abnormal = deviation of >10 mm
– need to check the ACL next
Forced Hyperextension Test
- indicated deficit
- how to do it
- positive
mobility deficit (meniscus tear)
pt supine, PROM knee maximally flexed, allow for leg to drop, should drop into extension
- if pt has pain or leg moves far into hyperextension
Thessaly Test
- indicated deficit
- how to do it
- positive
mobility deficit (meniscus tear)
pt standing on affected leg with hand supported, flex knee slightly and have pt rotate medially and laterally
pain in medial/lateral joint line as well as clicking or popping
McMurray’s Test
- indicated deficit
- how to do it
- positive
mobility deficit (meniscus tear)
pt in supine with knee maximally flexed passively
ER = Medial Meniscus biased
IR = Lateral Meniscus biased
reproduction of pain, clicking and popping
Anterior Drawer Test
- indicated deficit
- how to do it
- positive
movement coordination (ACL tear)
hooklying
stabilize the foot/leg
place thumbs on anterior surface of joint line
move tibia anteriorly and assess for laxity/end feel
abnormal laxity/absent end feel compared bilaterally
Posterior Drawer Sign
- indicated deficit
- how to do it
- positive
movement coordination (PCL tear)
in hooklying with foot/ankle stabilized
palpate tibial plateaus
apply posterior force
assess for joint laxity/end feel
excessive posterior translation (>6mm)
absent end feel
Lachman’s Test
- indicated deficit
- how to do it
- positive
movement coordination (ACL tear)
hip and knee flexed, knee at 20-30 degrees
stabilize anterior surface of distal femur
place other hand on posterior surface of proximal tibia
apply an anterior directed glide through the tibia
excessive tibial translation (>6mm)
Posterior Sag Test
- indicated deficit
- how to do it
- positive
movement coordination (PCL injury)
pt hip/knees flexed to 90
assess position of tibial tuberosities
one knee posterior compared to the other
Active Quadriceps Test
- indicated deficit
- how to do it
- positive
movement coordination (PCL tear)
hooklying position with ankle/foot stabilized
have patient try to extend the knee
anterior translation of tibia during active contraction followed by posterior sag during relaxation
