Knee Tests

Question 1

1st elements of knee examination

Answer 1

Gait, functional movements ie.
Squats, lunges, sitting/standing. Toe touch, on leg stand.
What is the foot, ankle, lower leg, knee, femur, hip doing?
Valgus or Varus?
Pelvic levels

Question 2

Special history questions

Answer 2

Specific mechanism of injury?
Age? (Teenagers = plica syndrome) 
Pain up/down stairs?
Swelling? Sudden/slow
Running/walking surface

Question 3

Lachman’s test

Answer 3

ACL

20-30 degrees flexion with externally rotated slightly, the pull tibia anteriorly, push femur posteriorly.

Anterior translation of the tibia associated with a soft or a mushy end-feel indicates a positive test.

Question 4

Anterior draw

Answer 4

ACL

Patient supine with knee at 90° pulls tibia anteriorly.

Positive = pain, excessive motion

Question 5

Posterior lag sign

Answer 5

PCL

Patient supine with knees flexed at 90°. Compare prominence of tibial tuberosities bilaterally.

Question 6

Posterior draw

Answer 6

PCL

Patient supine with knee flexed at 90° and pushes knee posteriorly.

Positive = pain, increased motion

Question 7

Quad active test

Answer 7

PCL

Positive causes tibia to move anteriorly and eliminates posterior lag.

Question 8

Valgus stress test

Answer 8

MCL

Knee at 0° & 30°

Positive = pain, increased motion/gapping

Question 9

Varus stress test

Answer 9

LCL

Knee at 0° & 30°

Positive = pain, increased motion/gapping

Question 10

Apley’s

Answer 10

Meniscus

prone position with the knee flexed to 90 degrees and compress with rotation.

Positive = pain

Question 11

Thessaly / Disco

Answer 11

Meniscus

Stand on one leg and twist knee

Positive for pain

Question 12

McMurrays

Answer 12

Meniscus

From a position of maximal flexion, extend the knee with internal rotation (IR) of the tibia and a VARUS stress, then return to maximal flexion and extend the knee with external rotation (ER) of the tibia and a VALGUS stress.

Positive = Pain, snapping, audible clicking or locking can indicate a compromised meniscus.

Question 13

Patellar grind / Clarke’s test

Answer 13

To detect disorder (patellofemoral pain syndrome, chondromalacia patellae, patellofemoral DJD)

Positive = pain

Question 14

Waldron / squat test

Answer 14

Patellafemoral joint dysfunction - chondromalacia Patella

Palpate patella during squat and rise.

Positive = pain, grinding

Question 15

Single leg stance / hop

Answer 15

Patellar tendinopathy (strongly suggested when chondromalacia tests are negative

Pain with functional assessment, excessive pelvic movement = weak abdominals,

Question 16

Renne test

Answer 16

ITB pain/dysfunction

Standing squat, rise (pressure above lateral epicondyle & active knee flexion & extension). Best movement to replicate ITB tension

Question 17

Ober’s

Answer 17

Tight/contracted/inflamed TFL or ITB

Positive = the leg would remain in the abducted position and the patient would experience lateral knee pain

Question 18

Nobel’s

Answer 18

ITB Dysfunction

Same position as Ober’s but apply pressure over lateral epicondyle with passive knee flexion & extension.

Question 19

Ege’s test

Answer 19

Meniscus
Weight bearing McMurrays

Squat with feet turned outwards (medial meniscus) or inwards (lateral meniscus)