The knee examination is performed as part of the history and physical exam when a patient presents with knee pain.
The knee exam has several components:
- Motion of joint
As in all medicine a good history is the most important step in the evaluation and diagnosis of any problem. It has been written that a good history is 90% of diagnosing and it is no different with knee problems.
Movement is the observation of the gait as well as watching the overall body language as a patient walks out and away from the exam room, gets on and off the exam table, and stands and sits on the exam table. Also of note, is the use of assistive equipment such as a cain or a walker.
Inspection is done with the patient standing and sitting.
- Bakers cast – bulge back of knee
- Knocked kneed – valgus
- Bow legged – valgus
- Muscle atrophy
Seated or supine
- Lesions or rashes
- Ecchymosis (black and blue)
- Knee cap position
- Effusions (water in knee)
- Crepitus – grinding or a lose body feeling inside the knee
- Normal flexion to 135 degrees
- Normal extension to zero degrees
- Lateral stress tests lateral
- Medial stress test medial ligament
- Pulling forward tests posterior cruciate
- Pushing backward text posterior cruciate
- McMurry test-
- Text for all medial and lateral
- Tear of meniscus
- apply grind test