Knee

Question 1

McMurray sign

Answer 1

P: Clicking sound or pain by the knee joint

I: Tear of medial meniscus of positive on external rotation. Tear of lateral meniscus if positive on internal rotation. The greater the angle the knee is flexed when the positive is elicited the more posterior the meniscal injury.

Question 2

Medial collateral ligament test

(abduction stress test; valgus stress test0

Answer 2

P: Gapping and/or elicited pain above/at/below joint line

I: Tear and/or instability of the medial collateral ligament

Question 3

Lateral collateral ligament test

adduction stress test; varus stress test

Answer 3

P: Gapping and/or elicited pain above/at/below joint line

I: Tear and/or instability of the lateral collateral ligament

Question 4

Bounce home test

Answer 4

P: Knee does not go into full extension (slight flexion remains)

I: Diffuse swelling of the knee or accumulation of fluid, due to possible torn meniscus

Question 5

Drawer test (knee)

Answer 5

P (1): Gapping >6 mm when the leg is pushed (tibia moves posterior)
I (1): Torn posterior cruciate ligament

P (2): Gapping >6 mm when the leg is pulled (tibia moves anterior)
I (2): Torn anterior cruciate ligament

Question 6

Lachman test

Answer 6

P: Gapping with the tibia moving away from the femur
I: Anterior cruciate ligament or posterior oblique ligament instability

Question 7

Apprehension test for the patella

Answer 7

P: Apprehension, distress of facial expression, or contraction of the quadriceps to bring the patella back in line

I: Chronic patella dislocation or pre-disposition to dislocation

Question 8

Patella femoral grinding test

aka Clark sign

Answer 8

P: Retro-patellar pain and the patient is unable to hold the quadriceps contraction

I: Degenerative changes of the patellar facets and/or within the trochlear groove (chondromalacia patella)

Question 9

Patella ballottment test

Answer 9

P: A floating sensation of the patella

I: A large amount of swelling in the knee

Question 10

Apley compression test

Answer 10

P: Patient points to the side of pain

I: Pain on the medial side is medial meniscus tear. Pain on the lateral side is lateral meniscus tear.

Question 11

Apley distraction test

Answer 11

P: Patient points to the side of pain

I: Pain on the medial side is medial collateral ligament tear. Pain on the lateral side is lateral collateral ligament tear.