Musculoskeletal Examination [Complete]

Question 1

Please assess the gait of the patient.

Answer 1

“Id like to ask you to stand up for me and walk to the end of the room then turn around and walk back to me”

Question 2

Please palpate and assess the joint temperature

Answer 2

“I am now going to feel the temperature of the knee. Please let me know if you have any pain at all”

Use the back of your hand, starting at the thigh and moving down towards the knee

Question 3

Please palpate the flexed knee, feeling for the medial and lateral joint line and the popliteal fossa

Answer 3

“Im now going to feel around the knee joint. Please place your foot on the bed so that it flexes yout knee. Please let me know if you are experiencing any pain”.

First palpate along the patellar tendon. (e.g. start at inferior border of patella and stop at tibial tuberosity)

Feel along the medial and lateral joint lines which is along the patellar tendon to the epicondyle of the femur (prominence on the sides of the knee)

Then feel for the popliteal fossa at the back of the knee

Question 4

Please assess for joint effusion by performing either the patellar tap or sweep/bulge test

Answer 4

Sweep/bulge test: Swipe up towards the suprapatellar pouch on the medial side of the leg. Wait for fluid to accumulate and swipe down with other hand from lateral side of suprapatellar puch

Question 5

Please assess active range of movement of the knee joint of the left/right lower limb and report the estimated range of motion in degrees.

Answer 5

“Could you bend your right knee as much as you can for me”

“Now can you straighten your leg out for me”

Normal range: 0-140 degrees

“Now do the same on the left hand side”

Question 6

Please assess passive range of movement of the knee joint of the left/right lower limb and report the estimated range of motion in degrees.

Answer 6

“Im going to assess the passive range of movement of the knee joint so id just like you to relax your legs for me”

“Please let me know if you are experiencing any pain”

Support by holding the ankle and knee

Normal range: 0-140 degrees

N.B. Can also assess for hyperextension during this (greater than 10 degrees is abnormal)

Question 7

Please perform the anterior drawer test

Answer 7

“Could you please put your foot on the bed. I am now going to perform a test which will require me to sit on your leg to stabilise your leg if thats okay.”

Place both hands round the upper tibia, with your thumbs over the tibial tuberosity and index fingers tucked under the hamstrings to make sure these are relaxed.

Question 8

Please perform the posterior drawer test

Answer 8

“Could you please put your foot on the bed. I am now going to perform a test which will require me to sit on your leg to stabilise your leg if thats okay.”

Place both hands round the upper tibia, with your thumbs over the tibial tuberosity and index fingers tucked under the hamstrings to make sure these are relaxed.

Question 9

Please assess the integrity of the medial and lateral collateral ligaments

Answer 9

“Im now going to lift each leg and apply some pressure to each side please relax your leg for me”

Lift up the leg then hold the thigh in one hand and the leg below the knee in the other.

Pull the leg laterally to assess the medial collateral ligament

Push the leg medially to perform the lateral collateral ligament