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 -> 1^st 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