Knee Examination Flashcards
Observation
Sitting - legs treated the same?
Standing - valgus (knees inwards) or varus (knees outwards), Q angle (ASIS to patella tendon), leg length, patella size and position (alta; small, baja; low), hyperextension, whole kinetic chain
Functional tasks
Activity that reproduces symptoms
Gait
Sit-stand
Lunge
Hopping
Full squat
Sing leg stand - eyes open and closed
Single leg squat
Palpation
Skin - temperature, swelling, allodynia
Medial and lateral collateral ligaments
Joint line - meniscus
Patella
Prepatellar, suprapatellar (hold patella between thumb and index finger, roll down the suprapatellar bursa, thumb and finger move out majorly caused by increased fluid) and infrapatellar bursa
Ischial tuberosity - hamstring tendons
Pes anserine - medial tibia, below joint line, tibial tuberosity level, insertion for Semitendinosus, gracilis and sartorius
Plica - medial to patella over femoral condyle
Pulses - popliteal, posterior tibial, dorsal pedis
Active range of motion
Supine - flexion, extension, medial and lateral rotation (knee at 90 degrees)
Edge of bed - extension, medial and lateral rotation (knee at 90 degrees)
Passive range of motion
Over pressure
Flexion, extension, medial and lateral rotation
Isometric
Apply force and get patient to resist
Quadriceps
Hamstrings
Oxford scale
Muscle length
Hamstrings - popliteal angle, 90 at hip and knee, straighten the knee
Quadriceps - heel to buttock in prone
Thomas test - hip flexors, edge of bed, hold knee up and roll back, shoulder be flush
Ligament testing: ACL
Knee bent at 90 or 30 degrees
Sit on patients foot
Thumbs on tibia condyle and wrap fingers around the back of the leg
Pull the tibia forwards towards you
Should feel the end of range
Ligament testing: PCL
Knee bent at 90 degrees
Sit on patients foot
Place groove of palm on tibia tuberosity
Other hand on lower femur to stabilise
Push hand back towards the patient
Should feel the end of range
Ligament testing: MCL
Knee bent at 20 degrees
One hand under calf to support the leg
Other hand on the outside of the knee
Raised and pointed elbows
Push the knee inwards towards the other knee
Should feel the end of range
Ligament testing: LCL
Knee bent at 20 degrees
One hand under calf to support the leg
Other hand on the inside of the knee
Raised and pointed elbows
Push the knee outwards away from the other knee
Should feel end of range
Menisci testing: McMurry’s
Flex hip and knee
Hand on the heel of foot of patient other on knee joint
Internally or externally rotated the knee, then slowly extend the knee
Should be looking/feeling for clicking, locking or giving way
Varus or valgus
Menisci testing: Thessaly
Patient stand on one leg
Knee bent to different degrees
Get the patient to rotate their knee and body
