Knee Exam Notes INSPECTION Have patient standing o Feet shoulder with o Obvious deformity, alignment (varus or valgus)

) o Observe feet (pes planus or pes cavus) o Observe feet for pronation and supination Patient in supine o Warmth or erythema of knee (always compare to other side) o Quadriceps musculature (contract tone and atrophy) o Effusion Milk down from suprapatellar aspect and lateral aspect and look for bulging on medial aspect

PALPATION ROM Place leg in full extension and look for hyper extension Full flexion (knee bent) Knee in slight flexion (pillow under knee) Palpate quadriceps muscle and tendon Patella (superior, inferior, medial, and lateral aspects, patellar tendon and fat pads on either side of the tendon) MCL Pes anserine area (3cm below joint line) LCL Fullness or mass in poplitieal fossa Bursa (prepatellar, infrapatellar, pes anserine)

STRENGTH Have patient kick out and lift up

SPECIAL TESTS Knee in extended position Patellar apprehension test patellar dislocation o Pressure on medial patella and move laterally and see if sign of apprehension on patients face Patellofemoral grind test asses Patellofemoral joint surfaces o Press down on the patella and have patient flex quadriceps o Feel for crepitus or pain Lachman and Anterior drawer (integrity of ACL) o Lachman knee in 25 degrees (put your knee under patients)

More sensitive o Anterior drawer (and posterior drawer for PCL) knee in 90 degrees Posterior Sag sign (integrity of PCL) Varus and Valgus (LCL and MCL) o Abduct hip and flex knee to 30 degrees o Provide respective stresses Meniscal pathology o Palpate joint line at medial and lateral aspect o McMurrays test complete knee flexion and internally and externally rotate