Knee examination Flashcards
What is the exposure for knee exam?
lower limbs exposed - keep underwear on
In which MSK exams is body habitus important to inspect for and why?
Hip and knee because increased mechanical load can cause osteoarthritis in hip and knee
What scars may you see on the knee?
Arthroscopy port entry site
midline scar from knee replacement
What should you check for from the front of knee exam?
Valgus/Varus deformity
Patellar position
Knee swelling
Describe a valgus deformity
The tibia is turned outward in relation to the femur
Describe a varus deformity
The tibia is turned inward in relation to the femur
What should you check on inspection from the side?
Knee hyperextension
Fixed flexed deformity at the knee
What may cause hyperextension in the knee?
Cruciate ligament
What should you look for on inspection of the knee from behind?
Scars
Muscle wasting
Popliteal swellings
What can cause popliteal swelling?
Baker cyst
Where do you measure the quadriceps?
20cm above the tibial tuberosity
What might a hot knee joint suggest?
Septic arthritis
Inflammatory arthritis
Gout
Pseudogout
What might tenderness on palpation fo the medial and lateral border of the patella mean?
Patellofemoral arthritis
What might pain on palpation of the patellar tendon mean?
Tendonitis or rupture
What things can cause joint effusion?
Ligament rupture (e.g. anterior cruciate ligament), septic arthritis, inflammatory arthritis and osteoarthritis
What might tenderness of the medial and lateral joint lines (inc the collateral ligaments) demonstrate?
- Fracture
- Meniscal injury e.g. meniscal tear
- Collateral ligament injury (e.g. rupture)
What might tenderness over the tibial tuberosity suggest?
Osgood-Schlatter disease
What can popliteal fossa palpation demonstrate? (2)
Popliteal cyst (Baker's cyst) Pulsatile mass = popliteal aneurysm
What is the normal ROM of active knee flexion?
0-140 degrees
What is the normal ROM of active knee extension?
180 degrees
What is the normal ROM of PASSIVE knee flexion?
0-140 degrees
What are the special tests for knee examination?
- Posterior sag sign
- Anterior drawer test
- Posterior drawer test
- Lachman’s test
- Varus stress test
- Valgus stress test
- McMurray’s test
What is a positive posterior sag sign and explain the pathophysiology
The posterior cruciate ligament prevents the backwards displacement of the TIBIA or forward sliding of FEMUR
Hence, if the PCL is ruptured the tibia can sag posteriorly in relation to the femur
What does Lachman’s test assess?
Laxity or rupture of the ACL
What is the test for a meniscal tear?
McMurrays
What are menisci?
Fibrocartilagenous tissue which function to stabilise the knee joint and distribute friction between the femur and tibia
How can one injury their menisci?
Sudden twisting of the knee
What are the symptoms of a meniscal tear?
Sudden onset pain
Popping sensation
Locking
Instability of the knee joint
How do you complete a knee examination
Neurovascular examination of both lower limbs
Examination of the joint above (the hip)
Examination of the joint below (ankle)
Further imaging
