Knee exam

Question 1

Order of knee exam

Answer 1

Introduce self
Confirm identity
Inspection
Palpation
Active ROM
Passive ROM
Patellar Tracking
Joint Line tenderness
Gait
Muscle Testing
Special Tests

Question 2

Inspection of knee

Answer 2

Check anterior and posterior for asymmetry, bony deformities, swelling, redness, nodules, muscle atrophy

Question 3

Palpation of knee

Answer 3

Patella
Patellar tendon
Quadriceps tendon
Infrapatellar bursa
Tibial tuberosity
Other soft tissue areas

Palpating for tenderness, bogginess, and bone enlargement

Question 4

Active ROM knee

Answer 4

Flexion and extension

Question 5

Passive ROM knee

Answer 5

Flexion and extension, feeling for crepitus, tenderness

Question 6

Patellar tracking

Answer 6

Have patient flex and extend knee and observe movement of patella bilaterally
Abnormal result = patellar instability

Question 7

Joint line tenderness

Answer 7

Pain = torn meniscus or arthritis

Question 8

Gait

Answer 8

Assess gait and describe one possible abnormal gait

Question 9

Muscle test

Answer 9

Quadriceps- Push up against hand
Hamstring- push down on hand

Question 10

Special tests

Answer 10

Patellar apprehension sign- knee relaxed and flexed at 30 degrees medially and laterally displace patella; if apprehension suggests patellar instability
Patellar grind test- Apply downward pressure to superior patella while patient contracts quadricep; pain, crepitus indicates chondromalacia or patellofemoral syndrome
McMurray Test: medial meniscus, hip and knee flexed, external rotation and valgus stress while extending knee, painful click = tear
lateral meniscus, hip/knee flexed, internal rotation, varus stress while extending knee, painful click = tear
Valgus stress test= Knee extended or flexed at 30 degrees, perform test and pain indicates mcl damage
Varus stress test = knee extended or flexed at 30 degrees, varus stress, pain indicates lateral collateral damage
Lachman = Stabilize femur and pull anterior on tibia with other hand, anterior subluxation = ACL rupture
Pivot shift =Start in extension, flex and internally rotate knee while placing valgus stress, indicates ACL rupture
Anterior drawer = stabilize foot and use both hands to pull on tibia, indicates ACL rupture
Posterior drawer = stabilize foot and use both hands to push on tibia posterior = PCL rupture
Noble’s test = Apply pressure over lateral femoral condyle and passively extend knee, pain = IT band syndrome
Ober’s test = Pt lies on one side, extend hip flex knee adduct hip dripping below hip level, lack of adduction = IT band syndrome

Question 11

perform the knee exam!

Answer 11

did you do it?