1 / 18

Knee Examination

Knee Examination. Kathy Rainsbury February 2008. How to diagnose a knee complaint - HISTORY. 1) Patient’s age + sex 2) Does the knee swell? 3) Is there a mechanical problem?. Age + sex. Swelling?. Effusion presence of pathology which must be investigated

huong
Download Presentation

Knee Examination

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Knee Examination Kathy Rainsbury February 2008

  2. How to diagnose a knee complaint - HISTORY • 1) Patient’s age + sex • 2) Does the knee swell? • 3) Is there a mechanical problem?

  3. Age + sex

  4. Swelling? • Effusion • presence of pathology which must be investigated • XS synovial (inflammatory) fluid/ blood/ pus • Absence of effusion • Does not exclude pathology, but less likely. • Long-standing meniscus lesions/ OA

  5. Mechanical problem? • Hx of initial injury ‘mechanism’ • Degree + direction + incapacity • Knee ‘give way’? • Going down stairs/ jumping : cruciate ligament • Twisting/ walking/ uneven ground: meniscus • Knee ‘locks’? • NEVER locks in full extension • Full flexion but limited extension – FB + meniscal (‘click’) • Pain • When? Localise?

  6. Investigations • Examine other joints (? Rheumatoid/ psoriasis + other inflammatory arthropathies) • Aspiration + culture of fluid • Bloods • Xray joint (? use) • CXR (if ? TB) • MRI • EUA • Arthroscopy

  7. Examination • Look • Measure • Feel • Move

  8. Surface anatomy

  9. Surface anatomy 2 10 1 - Joint line 5

  10. Inspection (ant. + post.) • Symmetry • Swelling/ bruising/ scars/ rash/ deformity/ wasting/ bursae • (Heat) • Patella position – quads/ extensor apparatus intact?

  11. Measure • Quads circumference

  12. Palpate • Effusion – patellar tap • Fluid displacement • Tenderness • Bend knee – joint line • Collateral ligaments • Tibial tubercle • Femoral condyles

  13. Move • Active + passive • Extension – 0 deg (? Hyperextension) • Flexion – 135 deg

  14. Move - instability • 1) Valgus stress test (+ve if medial lig torn) • 2) Varus stress test ( +ve lat lig torn) • 3) Anterior Drawer test (+ve if ant cruciate torn) • Or Lachman test • 4) Posterior Drawer test (+ve if post cruciate torn)

  15. Instability - rotatory • MacIntosh test / pivot shift test (difficult if patient not under anaesthesia)

  16. Menisci • Feel for clicks, listen for crepitus • McMurrays test – medial + lateral menisci • (or Apley’s grind test)

  17. And finally… • Gait • Genu varum ‘varus my pig?’ • Genu valgus varus valgus

  18. http://www.youtube.com/watch?v=fNUGyNYVhqE • http://www.youtube.com/watch?v=IwBW-X4n1fU

More Related