Knee Physical Exam

  • WIPE, blah blah 🙂
  • “Take vital signs”
  • Proper exposure: both legs
  • General inspection of the patient + surroundings (walking aids)
  • Assess the pt’s gait

 

  • Look: (from all sides, while the pt is standing)
    • Skin changes (redness, discoloration, rash)
    • Scars
    • Swelling\bulging
    • Popliteal swelling\baker’s cyst
    • Muscle wasting (quadriceps)
    • Deformity (varus\valgus)
  • Feel: (first ask if they have pain?)
    • Temperature
    • Landmarks:
      • Bony: patella, tibial tuberosity\platue, epicondyles, prox fibula
      • Soft tissue: joint line tenderness, quadriceps, popliteal fossa
        • While you’re there, palpate the popliteal A
    • Effusion:
      • Bulge\milking sign (small effusion)
      • Patellar tap (large effusion)
  • Move: flexion + extension
    • Active
    • Against resistance comment on power
    • Passive “comment on ROM and crepitus”
  • Special tests:
    • ACL\PCL: ant\post drawer test (at 90°)
    • LCL\MCL: varus\valgus stress test (at 0° and 30°)
    • Meniscus: McMurray’s test
  • Neurovascular:
    • Tibial N:
      • M -> planter flexion
      • S -> sole of the foot
    • Deep peroneal N:
      • M -> foot dorsiflexion
      • S -> 1st web space
    • Superficial peroneal N:
      • M -> foot eversion
      • S -> dorum of the foot
    • Reflexes:
      • Patellar
      • Ankle jerk
    • Pulses:
      • Popliteal A
      • Dorsalis pedis A
      • Post tibial A
  • Joint above + joint below

 

 


Download the PDF version: here

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