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Knee Examination Dr.Kholoud Al- Zain

Knee Examination Dr.Kholoud Al- Zain. Acknowledgment: Dr. Abdulaziz Alomar. General MSK Physical Examination P rinciples for Lower Examination. Exposure Bilateral limb examination Anterior and posterior Gait LLD NV examination Joint above and joint below. Gait . Antalgic gait.

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Knee Examination Dr.Kholoud Al- Zain

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  1. Knee ExaminationDr.Kholoud Al-Zain Acknowledgment: Dr.Abdulaziz Alomar

  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 • Antalgicgait

  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 15 degree 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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