Knee: Examination 2

Question 1

Meniscal testing: McMurray

higher sensitivity or specificity

Answer 1

specificity (low to mod sensitivity)

Question 2

Meniscal testing: McMurray

Higher specificity for medial or lateral?

Answer 2

lateral

Question 3

Meniscal testing: McMurray (lateral)

specificity

Answer 3

94%

Question 4

Meniscal testing: McMurray

specificity - medial

Answer 4

77%

Question 5

Meniscal testing: What are the main special tests

Answer 5

• McMurray
• Apley compression
• JL tenderness
• Thessaly

Question 6

JL tenderness: more sensitive or specific?

Answer 6

sensitivity > specificity

Question 7

Meniscal testing: JL tenderness

sensitivity - medial

Answer 7

83%

Question 8

Meniscal testing: JL tenderness

sensitivity - lateral

Answer 8

68%

Question 9

Meniscal testing: Thessaly

sensitivity/specificity

Answer 9

• sens: 64%

- spec: 53%

Question 10

What is the meniscal cluster?

Answer 10

• hx catching or locking
• JL tenderness
• pain with flexion OP
• pain with ext OP
• pain or audible click with McMurray

Question 11

Meniscal Cluster: with 5/5 variables, get high specificity of

Answer 11

99%

Question 12

Meniscal Cluster: 4+ variables

specificity

Answer 12

96%

Question 13

Meniscal Cluster: high specificity, (high/low) sensitivity

Answer 13

low

Question 14

PFPS is a diagnosis of

Answer 14

exclusion

Question 15

PFPS: what to assess

Answer 15

• resisted knee ext through ROM
• step down test
• patellar mobility - apprehension test
• patellar compression
• posteromedial and lateral borders of patella
• strength testing

Question 16

functional testing: higher level

L to R comparisons should be within (%) for return to sport

Answer 16

80-85%

Question 17

functional testing: higher level

Commonly used tests

Answer 17

• Noyes hop tests
• Star excursion balance test
• Y balance

Question 18

functional testing: higher level

Noyes Hop Tests

Answer 18

• single hop for distance
• triple hop for distance
• timed 6m hop test
• cross over hop for distance

Question 19

functional testing: higher level
Y balance

Different > (#) cm in anterior direction = higher risk of injury

Answer 19

> 4 cm difference

Question 20

functional testing: higher level
Y balance

Difference in > 4 cm in anterior direction = (#)x risk of injury

Answer 20

2.5x risk of injury

Question 21

functional testing: lower level (list)

Answer 21

• timed stair climbing test
• 6MWT
• TUG
• 5x STS
• self-selected walking speed

Question 22

functional testing: lower level

What does the 6MWT measure?

Answer 22

submaximal aerobic capacity

Question 23

Red flags:

With normal knee exam or unexplained pain onset, consider:

Answer 23

• referral from lumbar, SIJ, hip
• lumbar radiculopathy
• SCFE
• OCD
• Legg-Calve-Perthes disease

Question 24

joint mobility: for flexion

(anterior/posterior) glide of tibia on femur

Answer 24

posterior

Question 25

joint mobility: for flexion | Superior/inferior patellar glide

Answer 25

inferior

Question 26

joint mobility: for extension | (anterior/posterior) glide of tibia on femur

Answer 26

anterior

Question 27

joint mobility: for extension | (superior/inferior) patellar glide

Answer 27

superior

Question 28

Flexibility: things to look at with the knee

Answer 28

- hip IR/ER - hip flexors/extensors - quads - HS - ankle DF (gastroc/soleus)

Question 29

Strength: quad deficits of ≥ (%) L to R indicate using NMES

Answer 29

15-20%

Question 30

Strength: be sure to incorporate these types of exercises

Answer 30

single leg | eccentrics

Question 31

Strength: increased injury risk with imbalances between

Answer 31

quadriceps to hamstring strength ratio

Question 32

Strength: for return to sport, males should have > (%) quad to ham ratio

Answer 32

> 66%

Question 33

Strength: for return to sport, females should have > (%) quad to ham ratio

Answer 33

> 75%

Question 34

Motor control: use these

Answer 34

- balance - dynamic joint stability training - perturbation exercises - plyometrics - agility and coordination training - sport specific exercises