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Knee Examination

Knee Examination. Abdulaziz Alomar, MD, MSc , FRCSC Assistant Professor and Consultant Orthopaedic and Sport Medicine Surgeon . General MSK Physical Examination P rinciples for Lower Examination. Exposure Bilateral limb examination Anterior and posterior Gait LLD NV examination

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Knee Examination

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  1. Knee Examination Abdulaziz Alomar, MD, MSc, FRCSC Assistant Professor and Consultant Orthopaedic and Sport Medicine Surgeon

  2. General MSK Physical Examination Principles for Lower Examination • Exposure • Bilateral limb examination • Anterior and posterior • Gait • LLD • NV examination • Joint above and joint below

  3. Gait • Antalgic gait • Stiff knee gait • Flexed knee gait

  4. Knee Examination • Look (Inspection) • Feel (Palpation) • Move • Special tests

  5. Inspection (Look) • Deformity • Scars • Swelling • Skin colour changes • Muscle wasting

  6. Muscle wasting

  7. Deformity Deformity

  8. Scars

  9. Localize Swelling

  10. Defuse swelling (Effusion)

  11. Feel (palpation) • Temperature • Tenderness • Effusion

  12. Tenderness • Soft tissue • Bony prominences • Joint line

  13. Surface anatomy

  14. Joint line palpation

  15. Effusion Ballotment Milking

  16. MOVE Active ROM Passive ROM

  17. ROM • Flexion contracture • Extension lag

  18. Special tests • Ligaments (stability): • ACL (Anterior Cruciate Ligament) • PCL (Posterior Cruciate Ligament) • MCL (Medial Collateral Ligament) • LCL (Lateral Collateral Ligament) • meniscus • Patellofemoral joint

  19. ACL (anterior cruciate ligament) Anterior drawer test • Excessive forward movement of the tibia on the femur

  20. ACL (anterior cruciate ligament) Lachman’s test • The most sensitive test for ACL rupture • Anterior Translation and end point (soft vs. hard)

  21. ACL (anterior cruciate ligament) Pivot shift test: When positive, it is painful It needs experience to be able to elicit it

  22. PCL (posterior cruciate ligament) Posterior drawer test • excessive backward movement of the tibia in relation to the femur.

  23. PCL (posterior cruciate ligament) 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.

  24. MCL Full extension 15degree flexion

  25. LCL Full extension 15 degree of flextion

  26. Meniscus • Joint line tenderness: • Tenderness in the medial joint line (medial meniscus) • Tenderness in the lateral joint line (lateral meniscus) • McMurrey’s test for medial and lateral meniscus

  27. Patella apprehension test

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