Knee ExaminationAbdulaziz Al-Ahaideb
MD,FRCSC
Orthopedic physical exam:
LookFeelMove
Special tests
Look (always compare)
Alignment ( normal, varus or valgus)Effusion Scars
WastingColor
P.S. don’t forget to inspect the posterior aspect ( e.g. Baker’s cyst)
Feel Temperature (compare)
Tenderness ( feel the bony prominences)
Effusion (fluid collection) * fluctuation
* bulging (milking) * ballotment (patellar tapping)
Move Active ( by the patient)Passive ( by the physician)Feel for crepitus when you take the knee through the range of motion
Special testsMeniscus
Stability
Meniscal examTenderness in the medial joint line (medial meniscus)Tenderness in the lateral joint line (lateral meniscus)McMurrey’s test for medial and lateral meniscus: (VC*)
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)
Stability MCL : Valgus stress test LCL : Varus stress test
Valgus stress test ( for MCL ) (VC*)
ACL examAnterior drawer Anterior drawer testtest:Excessive forward movement of the tibia on the femur
ACL exam
Lachman’s test Lachman’s test (VC*)(VC*):The most sensitive test for ACL rupture
ACL examPivot shift test:Pivot shift test:When positive, it is painfulWhen positive, it is painfulIt needs experience to be able It needs experience to be able
to elicit itto elicit it
PCL examPosterior drawer test Posterior drawer test (VC*):(VC*):excessive backward movement of the tibia inrelation to the femur.
PCL examSagging sign:Sagging sign: compare bothknees in 90 degrees of flexion.
In the injured knee the proximal tibia is displaced backwards compared to the otherside.
Sagging Sign
Patellar Apprehension test For recurrent patellar
dislocations/subluxations
Thanks