Knee Examination

Question 1

Inspect

Answer 1

{always ensure adequate exposure}
@front = quads wasting VASTUS MEDIALIS OBLIQUCUS ; patella pointing; swelling; valgus or varus alignment; scars; feet (medial arches, valgus deform of toes)

@ side = fully bracing back knees? Pro/recurvatum

@back = hammy wasting; calves wasting; soft tissue swelling; valgus/ varus heels

Question 2

Gait

Answer 2

[ walking aides,shoes and orthotics]

Antalgic
Stiff knee
Varus/valgus knee thrust
Collapse knee

Question 3

Look

Answer 3

[ ask if there is pain 1st]
Scars, swellings, quads wasting, skin 🔼
Asses quads= ask pt to push knees into bed.

Question 4

Feel

Answer 4

Temp/ erythema
[Assess active extension before lying down.]
Now lie pt down
Effusion = best assessed when lying down
= joint space starts 4 fingers above the patella
= PATELLA TAP only for mod to large effusions
Synovial mem thickening
Tenderness = quads tendon, patella, patella tendon, tib tuberosity

Question 5

Move

Answer 5

Passive extend knee
Extensor lag= @30^ fully extend ACTIVE movement
Flexion = active to bum, passive normal 120-135^

Question 6

Collateral and cruciate ligaments

Answer 6

MCL= knee up @ 20^ flex VALGUS stress& @ full ext.
LCL = varus force
ACL = LACHMANS TEST ➕ve if tib ant movement @ 15^ flex
= ant draw ➕ve if >1cm
PCL= post sag test
= post draw

Question 7

Meniscus test

Answer 7

Mc Murry - clicks @ joint
Apley’s grind
Childress test - duck walking