Download - Knee examination (lecture)
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Knee ExaminationAbdulaziz Al-Ahaideb
MD,FRCSC
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Orthopedic physical exam:
LookFeelMove
Special tests
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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)
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Feel Temperature (compare)
Tenderness ( feel the bony prominences)
Effusion (fluid collection) * fluctuation
* bulging (milking) * ballotment (patellar tapping)
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Move Active ( by the patient)Passive ( by the physician)Feel for crepitus when you take the knee through the range of motion
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Special testsMeniscus
Stability
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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*)
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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)
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Stability MCL : Valgus stress test LCL : Varus stress test
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Valgus stress test ( for MCL ) (VC*)
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ACL examAnterior drawer Anterior drawer testtest:Excessive forward movement of the tibia on the femur
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ACL exam
Lachman’s test Lachman’s test (VC*)(VC*):The most sensitive test for ACL rupture
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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
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PCL examPosterior drawer test Posterior drawer test (VC*):(VC*):excessive backward movement of the tibia inrelation to the femur.
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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.
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Sagging Sign
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Patellar Apprehension test For recurrent patellar
dislocations/subluxations
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Thanks