Knee

Question 1

Bony Palpation

Answer 1

Patella, medial tibial plateau, tibial tubercle, medial femoral condyle, lateral tibial plateau, lateral femoral condyle, fibula head.

Question 2

Soft Palpation

Answer 2

Quadraceps muscles (palpate as a unit and individually):  Vastus lateralis, vastus medialis, vastus intermedius, rectus femoris.
Infrapatellar tendon, Prepatellar bursae, superficial infrapatellar, medial meniscus, lateral meniscus, Pes anserine area(sartorius, gracilis, semitendinosus), popliteal fossa, lateral collateral ligament, medial collateral ligament, gastrocnemius muscle.

Question 3

McMurray Sign

Answer 3

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 positive is elicited, the more posterior the meniscal injury.

Question 4

Media Collateral Ligament Test a.k.a. Abduction Stress Test a.k.a. Valgus Stress Test

Answer 4

Positive: Gapping and or elicited pain above/at/or below joint line.
Indicates: Torn medial collateral ligament

Question 5

Lateral Collateral Ligament Test a.k.a Adduction Stress Test a.k.a Varus Stress test

Answer 5

Positive: Gapping and/or elicited pain above/at/or below joint line.
Indicates: Torn lateral collateral ligament.

Question 6

Bounce Home Test

Answer 6

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 7

Drawer Test

Answer 7

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

Question 8

Lachman Test

Answer 8

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

Question 9

Apprehension Test for the Patella

Answer 9

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

Question 10

Patella Femoral Grinding Test(a.k.a. Clarke sign)

Answer 10

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 11

Patella Ballottment Test

Answer 11

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

Question 12

Apley Compression Test

Answer 12

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

Question 13

Apley Distraction Test

Answer 13

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

Question 14

Range of Motion

Answer 14

Flexion: 135 degrees
Extension: 0 degrees
Internal Rotation
External Rotation