MSK Knee Flashcards
INTRODUCTION
- Clean your hands
- Give full name & status, ask patient details
- Check wrist bands and charts
- Explain what you would like to examine and wait for verbal consent
- Ask if patient is experiencing any pain
- Ask patient to remove any necessary clothing
LOOK
Standing first then lying on couch
- Symmetry and alignment
- Varus or valgus deformity
- Fixed flexion of the knee
- Rashes, wounds, scars or swelling
- Wasting of quadriceps muscles
FEEL
- Feel for temperature difference, comparing mid-thigh and knee of both legs
- Feel for tenderness along border of patella, extensor mechanism, and medial and lateral joint lines
- Feel behind the knee for popliteal cysts (Bakers cyst)
- Feel for knee effusion by performing patellar tap
- If no patella tap present, then assess for small effusion using bulge test
MOVE
- Active - flexion ask patient to fully flex knee towards buttock sand then full extension of knee
- Passive flexion and extension with one hand on knee to detect crepitus - assess and compare movement of both knees
- Assess for hyperextension by lifting legs by heels, looking for extension extension
COLLATERALS
* Flex knee to 20-30 degrees and apply lateral and medial stress to the knee, and repeat extended
* Excessive movement suggests damage to ligament or wear in medial or lateral compartment in older patients
CRUCIATE LIGAMENTS
* Posterior sag (draw) test - Observe the knees when hips are flexed to 45 degrees and knees flexed to 90 degrees
* Anterior draw test - position the hips at 45 degrees and knees at 90 degrees - attempt to draw the tibia forwards
MOVE
- Active - flexion ask patient to fully flex knee towards buttock sand then full extension of knee
- Passive flexion and extension with one hand on knee to detect crepitus - assess and compare movement of both knees
- Assess for hyperextension by lifting legs by heels, looking for extension extension
COLLATERALS
* Flex knee to 20-30 degrees and apply lateral and medial stress to the knee, and repeat extended
* Excessive movement suggests damage to ligament or wear in medial or lateral compartment in older patients
CRUCIATE LIGAMENTS
* Posterior sag (draw) test - Observe the knees when hips are flexed to 45 degrees and knees flexed to 90 degrees
* Anterior draw test - position the hips at 45 degrees and knees at 90 degrees - attempt to draw the tibia forwards
FUNCTION
- Ask the patient to walk, Observe for a limp, valgus/varus deformity or fixed flexion gait
- Examine hip and foot
CLOSURE
- Thank the patient
- Help them redress if requires and make them comfortable
- Doff PPE and dispose of safely
- Perform hand hygiene