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MSK > Knee MSK Assessment > Flashcards

Knee MSK Assessment Flashcards

1
Q

Components of knee exam

A
  • Inspection
  • Palpation
  • Active ROM
  • Passive ROM
  • Patellar tracking
  • Joint line tenderness
  • Gait
  • Muscle tests
  • Special tests
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2
Q

Muscle tests

A
  • Quadriceps
  • Hamstring
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3
Q

Special tests

A
  • Patellar Apprehension test
  • Patellar grind test
  • McMurray
  • Valgus stress
  • Varus stress
  • Lachman
  • Pivot shift test
  • Anterior drawer
  • Posterior drawer
  • Noble’s
  • Ober’s
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4
Q

Inspection

A

I am inspecting for
* deformities
* asymmetry
* swelling
* redness
* muscle atrophy
* etc

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5
Q

Palpation

A
  • Anterior and posterior
  • “I am palpating for tenderness, bogginess, and bone enlargement, etc.”
  • Patella
  • Patellar tendon
  • Quadriceps tendon
  • Infrapatellar bursa
  • Soft tissue areas
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6
Q

Active ROM

A

Flexion and extension

describe what you are looking/feeling for

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7
Q

Patellar tracking

A
  • Flex and extend knee and observe movement of patella bilaterally
  • Abnormal movement = patella instability
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7
Q

Passive ROM

A

Flexion and extension

describe what you are looking/feeling for

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8
Q

Joint line tenderness

A
  • Perform palpation and describe what abnormal result means
  • Pain = torn meniscus or arthritis
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9
Q

Gait

A
  • Assess gait and describe one abnormal gait
  • Trendelenburg = sway towards opposite side of muscle weakness
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10
Q

Muscle test - quadriceps

A
  • Have patient extend leg against resistance
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11
Q

Muscle test-hamstring

`

A
  • Patient prone, place knee in 90 degree flexion
  • Ask to flex against resistance
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12
Q

Special test- patellar apprehension sign

A
  • Patient supine with knees in 30 degree flexion
  • Displace knee laterally by applying medial pressure
  • What it means: patellofemoral syndrome, patellar subluxation, patellar dislocation
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13
Q

Special test: patellar grind test

A
  • Patient supine and knee fully extended
  • Place one hand superior to the patella and gently push the patella inferiorly as you instruct the patient to contract the quadricep
  • What it means: pain, crepitus indicates chondromalacia/patella femoral syndrome
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14
Q

Special test: mcmurray

A
  • Patient supine
  • Examiner on side of patient with one hand on heel while other is on the joint line
  • External rotation: valgus stress and slowly extending the leg = assess medial meniscus
  • Internal rotation: varus stress and slowly extending knee = assess lateral meniscus
  • What it means: click, popping, or pain = meniscus injury
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15
Q

Special test: valgus stress test

A
  • Abduct and flex knee to 30 degrees
  • Apply lateral (valgus) pressure
    • Medial joint laxity = MCL injury
16
Q

Special test: varus stress test

A
  • Abduct and flex knee to 30 degrees
  • Apply medial pressure
  • Lateral joint laxity = LCL injury
17
Q

Special test: Lachman

A
  • Patient supine with knee flexed approx 25-30 degrees. Patient instructed to relax the quadriceps muscle
  • Place one hand on distal femur and one on proximal tibia. Pull anteriorly on tibia
  • Increased anterior translation of tibia –> partial or complete tear of ACL
18
Q

Special test: pivot shift test

A
  • Generally under anesthesia
  • Patient seated with knee in full extension
  • Slowly flex the knee while applying a valgus stress and internal rotation
  • Subluxation will occur at 20-40 degree flexion, indicating dysfunction of the ACL. Usually with more severe Grade II or III tears
19
Q

Special test: anterior drawer test

A
  • Patient supine with hamstrings and quads relaxed and knee flexed to 90 degrees
  • Grasp proximal tibia with both hands and slide anteriorly
  • Anterior translation/joint laxity indicates ACL dysfunction
20
Q

Special test: posterior drawer test

A
  • Patient supine
  • Hamstrings and quads relaxed and knee flexed to approx 90 degrees
  • Grasp proximal tibia with both hands and slide tibia posteriorly. May sit on patient foot to provide stabilization
  • Posterior translation/joint laxity –> PCL dysfunction
21
Q

Special test: Noble’s test

A
  • Patient supine
  • Knee flexed to 90 degrees
  • Examiner applies pressure with finger/hand to lateral femoral condyle or 1-2 cm proximal to it as patient’s knee is passively extended
  • Tenderness over lateral femoral condyle at 30 degrees of flexion = IT band syndrome
22
Q

Special test: Ober’s test

A
  • Patient lying on unaffected side
  • Support affected knee and flex it to 90 degrees
  • Extend and abduct hip then release knee support
  • Failure of knee to adduct is positive –> IT band or tensor fascia lata tightness

MSK (11 decks)

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