knee exams

Question 1

adduction (varus) stress test

Answer 1

supine. knee is in extension place stress on medial aspect of the knee testing the lateral colateral ligament. if no symptoms flex knee to 30 degrees and stress again. if laxity or pain is felt at the lateral knee it is positive for lateral colateral ligament sprain

Question 2

apleys compression test

Answer 2

prone. patient flexes knee to 90 degrees and force is exerted on distal leg forcing tibia into the table to compress the knee joint. repeat with internal and external rotation. pain at the joint line indicates meniscal injury

Question 3

apleys distraction test

Answer 3

prone. patient flexes the leg to 90 degrees and dr places his knee on top of posterior thigh of the patient then force is exerted to distract the lower leg fro the knee. repeat with internal and external rotation. if pain is felt it is positive for collateral ligament injury.

Question 4

patella ballotment test

Answer 4

supine. knee flexed or extended to discomfort slightly tap or apply pressure to the patella. a floating sensation of the patella is a positive test. indication of knee swelling

Question 5

bounce home teat

Answer 5

supine. knee is flexed and dr grasps the ankle of affected leg and allows the knee to drop into full extension. if complete extension cannot be reached or has a rubbery end feel is a positive indication of a torn meniscus

Question 6

clarkes sign (patellar scrape test)

Answer 6

supine. affected knee is extended press down with the web of hand slightly proximal to the patella. if pain is felt below patella is positive for chondromalacia patella

Question 7

mcmurray sign

Answer 7

supine. flex the thigh and leg to 90 degrees, superior hand to lateral knee with inferior hand supporting patients heel internally rotate the lower leg and extend the knee applying valgus stress. retest with varus stress. positive if during range of motion a painful click or snap is heard. if heard with varus stress medial meniscus tear, if with valgus stress lateral meniscus tear

Question 8

lateral pivot shift test

Answer 8

supine. hip flexed to 20 degrees hold patients foot with one hand and flex the knee to 5 degrees with the other by placing the heel of the hand behind the fibula over the lateral head of the gastroc, medially rotate the tibia and apply valgus stress to the knee then flex th knee to 30 or 40 degrees. if tibia jogs backward it is positive for ACL injury

Question 9

lachmans test

Answer 9

supine. knee is placed between extension and 30 degrees of flexion. stabalize femur with superior hand then move proximal tibia in a p to a motion. if soft end feel and infrapatellar tendon slope disappears it is positive for ACL injury

Question 10

drawer test

Answer 10

supine. hip flexed to 45 degrees knee flexed to 90 degrees. sit on patients foot and apply force on the proximal tibia anterior and posterior. if greater than 6mm of movement posterior PCL injury if movement anterior ACL injury

Question 11

Q angle test

Answer 11

line from asis to midpoint of patella, line from tibial tubercle to mid point of patella and angle is measured above the knee. normal is 13 to 18 degrees. angle less than 13 degrees indicates patellofemoral dysfunction. if greater than 18 degrees increased femoral anteversion

Question 12

abduction (valgus) test

Answer 12

supine. knee is in complete extension and stress is placed against lateral aspect of the knee testing the medial collateral ligament. if no pain knee is flexed to 30 degrees and test is performed again. laxity or pain on medial aspect of knee is a positive for medial collateral ligament sprain