Knee Examination Abdulaziz Al-Ahaideb MD,FRCSC

Orthopedic physical exam: Look Feel Move Special tests

Look (always compare) Alignment ( normal, varus or valgus) Effusion Scars Wasting Color 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 tests Meniscus Stability

Meniscal exam Tenderness 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 exam Anterior drawer test Anterior drawer test: Excessive forward movement of the tibia on the femur

ACL exam Lachman’s test (VC*) Lachman’s test (VC*): The most sensitive test for ACL rupture

ACL exam Pivot shift test: When positive, it is painful It needs experience to be able to elicit it

PCL exam Posterior drawer test (VC*): excessive backward movement of the tibia in relation to the femur.

PCL exam Sagging sign: Sagging sign: compare both knees in 90 degrees of flexion. In the injured knee the proximal tibia is displaced backwards compared to the other side.

Sagging Sign

Patellar Apprehension test For recurrent patellar dislocations/subluxations

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