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    Knee Examination

    Uploaded by

    Wasim R. Issa
    This document provides an overview of how to examine the knee. It describes examining the knee in different positions including standing, sitting, supine, and prone. Key areas to examine include looking for deformities, gait abnormalities, swellings, discoloration, and wasting of the quadriceps muscle. Important tests involve feeling for temperature differences, tenderness along joint lines and attachments, and examining range of motion and laxity through special tests like the drawer test, Lachman's test, and McMurray's test. Measurements of Q-angle, patellar height and width, and quadriceps girth are also recommended. The hip and lymph nodes should also be examined to fully evaluate the knee.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd

    Knee Examination

    Uploaded by

    Wasim R. Issa
    261 views40 pages
    This document provides an overview of how to examine the knee. It describes examining the knee in different positions including standing, sitting, supine, and prone. Key areas to examine include looking for deformities, gait abnormalities, swellings, discoloration, and wasting of the quadriceps muscle. Important tests involve feeling for temperature differences, tenderness along joint lines and attachments, and examining range of motion and laxity through special tests like the drawer test, Lachman's test, and McMurray's test. Measurements of Q-angle, patellar height and width, and quadriceps girth are also recommended. The hip and lymph nodes should also be examined to fully evaluate the knee.

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    Knee Examination

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    Knee Examination - Copy

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    This document provides an overview of how to examine the knee. It describes examining the knee in different positions including standing, sitting, supine, and prone. Key areas to examine include looking for deformities, gait abnormalities, swellings, discoloration, and wasting of the quadriceps muscle. Important tests involve feeling for temperature differences, tenderness along joint lines and attachments, and examining range of motion and laxity through special tests like the drawer test, Lachman's test, and McMurray's test. Measurements of Q-angle, patellar height and width, and quadriceps girth are also recommended. The hip and lymph nodes should also be examined to fully evaluate the knee.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    261 views40 pages

    Knee Examination

    Uploaded by

    Wasim R. Issa
    This document provides an overview of how to examine the knee. It describes examining the knee in different positions including standing, sitting, supine, and prone. Key areas to examine include looking for deformities, gait abnormalities, swellings, discoloration, and wasting of the quadriceps muscle. Important tests involve feeling for temperature differences, tenderness along joint lines and attachments, and examining range of motion and laxity through special tests like the drawer test, Lachman's test, and McMurray's test. Measurements of Q-angle, patellar height and width, and quadriceps girth are also recommended. The hip and lymph nodes should also be examined to fully evaluate the knee.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 40

    Knee Examination

    Dr.Wasim R. Issa
    Look
    Position
    Standing
    Siting
    Supine
    Prone
    Look : Standing
    Normally : knees are in slight valgus position
    (about 7 deg in women and 5 deg in men).

    Deformities :
    Genu Valgum (Knock Knees)
    Genu Varum(Bow Legs)
    Genu Recurvatum
    Flexion deformity
    Windswept deformity
    Cavus foot
    Patellofemoral abnormality
    Flat foot

    Gait :

    Antalgic gait >>> knee arthritis


    Quadriceps avoidance gait .
    Hand to knee gait in quadriceps weakness
    Signs with the patient in Supine
    position
    Swellings
    Diffuse
    localize

    Discoloration around the knee joint

    bruising >> trauma of soft tissue or


    ligaments around the knee joint.

    Scars .

    Sinuses >>> infections.

    Quadriceps >> wasting and loss of bulk.


    Look in popliteal area for any
    obvious swelling

    - Bakers cyst
    - Gastrocnemius-
    semimembranosus bursa
    - Popliteal artery aneurysm
    - Lymphadenopathy
    - Soft tissue tumors
    Feel
    Temperature:
    - proximal to distal
    - Comparison

    - Tenderness:
    - Knee flexed at 90, examined for
    - Tenderness along the medial & lateral joint line
    - Localised tenderness around the joint line indicates injuries to the
    meniscus,collateral ligament and fat pad injuries.

    - Knee extremely flexed


    - Tenderness over medial femoral condyle just medial to patellar lig
    - (osteoarthritis dessicans of medial femoral
    epicondyle)
    Knee extended:

    - Tibial tuberosity
    - Osgood schlatters disease
    - acute avulsion injuries of the patellar ligament.
    - femoral condyle
    - Tibial condyle
    - Patellar tendon >> tendonitis
    - Attachement site of collateral ligaments
    PATELLA:
    trauma cases to look for fractures.

    Displace the patella medially and laterally and


    palpate the articular surfaces.
    Tenderness is found in Chondromalacia patellae.

    Move the patella in all the directions.


    Reduced mobility is found in Retropatellar arthritis.

    Tenderness over the lower pole of patella is found


    in Sinding-Larsen-Johansson disease.
    Pulses
    Knee dislocation

    ABI
    At least 0.9
    Move
    First active movement and

    then passive movement

    Normal Range of Motion:

    - Flexion : 0 135/140
    - Extension : 0 5 (hyperextension)
    - Adduction : 0 5
    - Abduction : 0 5
    - Internal rotation : 5 7 or 10
    - External rotation : 5 7 or 10
    MEASURE
    a. For position of patella:

    Flex knee at 30

    Measure height of patella (H) & length of patellar tendon


    (L)

    Findings:

    - L= H : normal
    - L H : patella alta
    - L H : patella baja
    b. Q-angle:

    Patient sitting on edge of couch

    Leg full extension

    2 lines
    - ASIS to centre of patella
    - Centre of patella to tibial tuberosity

    Measure angle (normally 14 in male & 17 in


    female)

    Increase in angle : valgus deformity (predisposing


    factor for chondromalacia)
    c. Girth of Quadriceps femoris:

    Measure 15 20 cm above the margin of base of


    patella

    23
    SPECIAL TESTS:

    1. For joint effusion

    a. Patellar tap

    b. Bulge test

    c. Juxta patellar hollow test


    Patellar tap:
    The Bulge test:
    patellar hollow test:
    2. For stability of joint:

    a. For cruciate ligaments

    i) Anterior cruciate ligamnent (ACL)


    Anterior drawer test
    Lachmans test

    ii) Posterior cruciate ligament (PCL)


    Posterior drawer test
    Sag test

    iii) Complex ligament injury


    Pivot shift test
    Anterior & Posterior drawer test:
    Lachman test:

    30
    Sag test:

    31
    Macintosh's Pivot Shift Test:
    b. For collateral ligaments:

    i) Varus valgus stress test (in flexion)

    ii) Varus valgus stress test (in extension)

    iii) Appleys distraction test

    c. For meniscal injury:

    i) Mcmurrays test

    ii) Thassalys test

    iii) Appleys grinding test


    Varus valgus stress test

    Apleys distraction test:


    Apleys grinding test:
    McMurrays test:

    37
    Thessaly test:

    38
    Do not forget
    Hip examination
    LNs
    THANK YOU

    40 Knee Examination/ Sunil Baniya

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