Knee exam

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Observation (supine)[edit]

  • Ecchymosis (bruise)? Surgical scars?
  • Erythema or overlying rash/celulitis
  • Knee resting position
  • Knee effusion with obscured landmarks
  • Quadriceps muscle atrophy


Observation (standing)[edit]

  • Balanced weight on each leg
  • Genu varum or genu valgum deformity
  • Gait analysis
  • Hip, knee and ankle alignment
  • Presence of Baker cysts (inspect popliteal fossa with patient standing)

Palpation[edit]

  • Temperature
  • Joint line tenderness
  • Bony structures
  • Bursae and tendons

Range of motion[edit]

  • Normal flexion = 130 degrees
    • look for pain and crepitus
    • do active vs passive ROM
  • Normal extension = 10 degrees above horizontal

Knee effusion tests[edit]

  • patellar ballotment
  • knee milking
  • swipe test/bulge sign

Anterior Cruciate Ligament (ACL) Stability Tests[edit]

  • Lachman's Test (most sensitive)
  • Anterior drawer sign

Posterior Cruciate Ligament (PCL) Tests[edit]

  • Posterior drawer test
  • PCL sag test

Collateral ligament evalutation[edit]

  • Knee valgus stress test (Medial collateral ligament)
  • Knee varus stress test (Lateral colalteral ligament)

Meniscus Evaluation[edit]

  • McMurrays Test (external rotation and extension from full knee flexion for medial meniscal tear, internal rotation and extension for lateral mensicusus)
  • Apley's compression test (grind home test)

Other OSCE modules[edit]