MSK - Knee Flashcards
Procedure for examination
Inspection
Palpation
Move
Prepare the patient
Bare below mid-thigh
Ask if they have pain
3 parts to inspection
Patient Standing
Gait
Patient lying on couch
Inspection of patient standing
Limb alignment- any valgus or varus deformity Quadricep/hamstring muscle mass Popliteal fossa (swelling > Baker's cyst)
Inspection of gait
Symmetry
Pace
Any gross gait abnormality
Walking aids
Inspection of patient lying on couch
Local inspection of knee for: erythema or skin changes bruising scars hair changes swelling
Palpation procedure (9)
Temperature Straight leg raise Effusion tests Tibial tuberosity Patella tendon Patella tests Medial and lateral joint lines Medial and lateral collateral ligaments Cruciate ligament testing
Effusion tests and their indications
Medial gutter sweep test (small or no visible effusion) Patella tap (large effusion)
Patella tests and indications
Patella apprehension test (patella instability)
Patella grind test (patella-femoral OA)
Patello-femoral crepitation (patella-femoral OA)
If localised medial joint line pain?
Steinmans test
Twist foot away from midline
If localised lateral joint line pain?
Steinmans test
Twist foot toward midline
If pain on medial collateral ligament?
Stressing of medial (valgus)
Push leg away from affected side
If pain on lateral collateral ligament?
Stressing of lateral (varus)
Push leg away from affected side
Cruciate ligament tests and indications
Posterior drawer test (PCL injury)
Lachman’s test (ACL injury)
Move
Flexion
Extension- place hand on knee and lift ankle off couch (if it lifts then = hyperextension)
