Professional Documents
Culture Documents
Knee Examination
Knee Examination
Inspection
Palpation
Range of motion
Active and passive
Neurovascular Exam
Inspection
Skin
scars
trauma
erythema
Swelling
Muscle atrophy
normal quadriceps circumference
15 cm (quadriceps)
Asymmetry
Gait
antalgia
stride length
muscle weakness
Palpation
Joint line tenderness
Tenderness over soft tissue structures
pes anserine bursae
patellar tendon
iliotibial band
Range of Motion
Active and passive
flexion/extension normal range
10 extension (recurvatum) to 130 flexion
abduction/adduction
in full extension, essentially 0
at 30 flexion, a few degrees of passive
motion possible
Neurovascular Exam
Sensation
medial thigh - obturator
anterior thigh - femoral
posterolateral calf - sciatic
dorsal foot - peroneal
plantar foot - tibial
Motor
thigh adduction - obturator
knee extension - femoral
knee flexion - sciatic
toe extension - peroneal
toe flexion - tibial
Vascular
pulses
popliteal
dorsalis pedis
posterior tibial
ankle-brachial index
ABI < 0.9 is abnormal
ACL Injury
Large hemarthrosis
Quadriceps avoidance gait (does not actively
extend knee)
Lachman's test
most sensitive exam test
grading
ACL Injury
https://youtu.be/xLKX6L2TXmA
PCL Tear
Posterior sag sign
patient lies supine with hips and knees flexed to 90,
examiner supports ankles and observes for a
posterior shift of the tibia as compared to the
uninvolved knee
MCL Tear
Valgus instability = medial opening
30 only - isolated MCL
0 and 30 - combined MCL and ACL
and/or PCL
classification
Grade I: 0-5 mm opening
Grade II: 6-10 mm opening
Grade III: 11-15 mm opening
LCL Tear
Varus instability = lateral opening
30 only - isolated LCL
0 and 30 - combined LCL and ACL
and/or PCL
Varus opening and increased
external tibial rotatory instability at
30 - combined LCL and
posterolateral corner
Meniscus Injury
Joint line tenderness
Effusion
McMurray's test
flex the knee and place a hand on
medial side of knee, externally rotate
the leg and bring the knee into
extension
a palpable pop or click is a positive test
and can correlate with a medial
meniscus tear
Patellar Pathology
Large hemarthrosis
absence of swelling supports
ligamentous laxity and habitual
dislocation mechanism
Patellar Apprehension
Questions?