Orthopedic Diagnosis: Knee

Question 1

McMurray Sign

Answer 1

• Positive: Clicking sound or pain by knee joint
  
  • Indicates: Tear of medial meniscus if positive on external rotation. Tear of lateral meniscus if positive on internal rotation. The higher the leg is raised during extension when the positive is elicited, the more posterior the meniscal injury

Question 2

Medial Collateral Ligament Test

(Knee)

Answer 2

• Positive: Gapping and/or elicited pain above/at/or below joint line
  
  • Indicates: Tear or instability of the medial collateral ligament

Question 3

Abduction Stress Test

(Knee)

Answer 3

• Positive: Gapping and/or elicited pain above/at/or below joint line
  
  • Indicates: Tear and/or instability of the medial collateral ligament

Question 4

Valgus Stress Test

(Knee)

Answer 4

• Positive: Gapping and/or elicited pain above/at/or below joint line
  
  • Indicates: Tear and/or instability of the medial collateral ligament

Question 5

Lateral Collateral Ligament Test

(Knee)

Answer 5

• Positive: Gapping and/or elicited pain above/at/or below joint line
  
  • Indicates: Tear and/or instability of the lateral collateral ligament

Question 6

Adduction Stress Test

(Knee)

Answer 6

• Positive: Gapping and/or elicited pain above/at/or below joint line
  
  • Indicates: Tear and/or instability of the lateral collateral ligament

Question 7

Varus Stress Test

(Knee)

Answer 7

• Positive: Gapping and/or elicited pain above/at/or below joint line
  
  • Indicates: Tear and/or instability of the lateral collateral ligament

Question 8

Bounce Home Test

Answer 8

• Positive: Knee does not go into full extension (slight flexion remains)
  
  • Indicates: Diffuse swelling of the knee, accumulation of fluid due to possible torn meniscus

Question 9

Drawer Test

Answer 9

1. Positive: Gapping > 6mm (tibia moves posterior) when the leg is pushed
   
   • Indicates: Torn posterior cruciate ligament
2. Positive: Gapping > 6mm (tibia moves anterior) when the leg is pulled
   
   • Indicates: Torn anterior cruciate ligament

Question 10

Lachman Test

Answer 10

• Positive: Gapping with the tibia moving away from the femur
  
  • Indicates: Anterior cruciate ligament or posterior oblique ligament instability

Question 11

Apprehension Test for the Patella

Answer 11

• Positive: Apprehension, distress of fascial expression, contraction of quadriceps to bring patella back in line
  
  • Indicates: Chronic patella dislocation or pre-disposition to dislocation

Question 12

Patella Femoral Grinding Test

Answer 12

• Positive: Retropatellar pain and the patient is unable to hold the quadriceps contraction
  
  • Indicates: Degenerative changes of the patellar facets and/or within the trochlear groove (chondromalacia patella)

Question 13

Clarke Sign

Answer 13

• Positive: Retropatellar pain and the patient is unable to hold the quadriceps contraction
  
  • Indicates: Degenerative changes of the patellar facets and/or within the trochlear groove (chondromalacia patella)

Question 14

Patella Ballottment Test

Answer 14

• Positive: A floating sensation of the patella
  
  • Indicates: A large amount of swelling in the knee

Question 15

Apley Compression Test

Answer 15

• Positive: Patient points to side of pain
  
  • Indicates: Pain on medial side is medial meniscus tear. Pain on lateral side is lateral meniscus tear

Question 16

Apley Distraction Test

Answer 16

• Positive: Patient will point to side of pain
  
  • Indicates: Pain on the medial side indicates medial collateral ligament tear. Pain on lateral side indicates lateral collateral ligament tear