MSK: Knee exam

Question 1

What should you inspect?

Answer 1

Inspect knees and gait

Question 2

How should you palpate the knee?

Answer 2

Palpate knee and surrounding tissue with leg straight and relaxed
Test for joint effusion by emptying suprapatellar space
Palpate knee with leg at 90 degrees

Question 3

What active and passive movements should you perform?

Answer 3

Active and passive: Flexion and extension

Passive: Hyperextesion

Question 4

What special tests should you perform?

Answer 4

Drawer test:
Flex knee at 90 degrees, stabilise lower limb with forearm. Push, then pull and assess for movement
Lachmans:
Flex knee to 30 degrees, hold thigh with one hand and tibia with the other. Try and displace the tibia anteriorly.
Collateral ligaments:
Extend the patient’s knee fully. Hold the patient’s ankle between your elbow and side. Place your right hand along the medial aspect of the knee. Place your left hand on the lower limb (e.g. calf or ankle). Push steadily outward with your right hand whilst applying an opposite force with the left. If the LCL is damaged your hand should detect the lateral aspect of the joint opening up. Repeat for medial ligament.