Knee Examination

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Knee Examination

• Dr Abdulaziz Al-Ahaideb
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Orthopedic physical exam

• Look
• Feel
• Move
• Special tests

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Look (always compare)

• Alignment ( normal, varus or valgus)
• Effusion
• Scars
• Wasting
• Color
• P.S. dont forget to inspect the posterior aspect
  ( e.g. Bakers cyst)

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Feel

• Temperature (compare)
• Tenderness ( feel the bony prominences)
• Effusion (fluid collection)
• bulging (milking)
• ballotment (patellar tapping)

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Move

• Active ( by the patient)
• Passive ( by the physician)
• Feel for crepitus when you take the knee through
  the range of motion

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Special tests

• Meniscus
• Stability

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Meniscal exam

• Tenderness in the medial joint line (medial
  meniscus)
• Tenderness in the lateral joint line (lateral
  meniscus)
• McMurreys test for medial and lateral meniscus
  (VC)

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Stability

• To test the four ligaments of the knee
• MCL (Medial Collateral Ligament)
• LCL (Lateral Collateral Ligament)
• ACL (Anterior Cruciate Ligament)
• PCL (Posterior Cruciate Ligament)

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Stability

• MCL Valgus stress test
• LCL Varus stress test

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Valgus stress test ( for MCL ) (VC)

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ACL exam
Anterior drawer test Excessive forward movement
of the tibia on the femur
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ACL exam
Lachmans test (VC) The most sensitive test for
ACL rupture
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ACL exam

• Pivot shift test
• When positive, it is painful
• It needs experience to be able to elicit it

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PCL exam

• Posterior drawer test
• (VC)
• excessive backward
• movement of the tibia in
• relation to the femur.

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PCL exam

• Sagging sign compare both
• knees in 90 degrees of flexion.
• In the injured knee the proximal tibia is
  displaced backwards compared to the other
• side.

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Sagging Sign
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Patellar Apprehension test

• For recurrent patellar dislocations/subluxations

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Thanks