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CC Abdullah Husni

Examination of knee

 History:
o History of trauma
o pain
o swelling
o stiffness
o locking → indication of loss body inside the knee or torn
meniscus
o clicking → audible sound
 no pain → normal
 pain → Abnormal
o giving away
 Injured ligament.

 Examination:
o Inspection:
 Gait
 Deformity: fixed abnormal shape or position of joint and cant
be corrected actively or passively
 Swelling:
 Generalized:
o
Fibrosis, effusion (blood, puss)
 Localized ?
 Skin:
 Color, hear, sinuses, scars (surgical, traumatic)
 Muscles:
 Ant. → quadriceps
 Post.→ hamstring
o Palpation:
 Superficial:
 Temperature.
 Tenderness.
 Swelling (effusion) :
o
Fluid displacement test:
1. Squeeze the fluid from supra patellar pouch by
index and thumb toward the knee tell reaching
the upper border of patella.(*)
2. Continue holding the fluid and stroke from each
side → see fluid thrill

Edited By: Mohd Zahrani Hyperzahranism

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WWW.SMSO.CC Abdullah Husni

3. NB: the test will be –ve if the effusion is gross

and tens
o
Patellar tap test
1. same as step 1*
2. Push the patella toward the condoyle by using 3
fingers and the tip of the thumb forming squire.
3. feeling of click as the patella strike the condoyle
→ effusion
4. NB: the test will be –ve if the effusion is slight
and tens.
o Cross fluctuation test:
1. same as 1*
2. hold the patella by thumb and index finger and
move it medially and laterally
o palpable fluid wave test:
1. hold the patella by thumb from one side and the
fingers from other side
2. compress the hollows at the side of the joint
3. same as 1*
4. the compressing hand will feel the fluid
movement

 Deep:
 Bone contour
o
Tibial tubercle
 Soft tissue
o
Patellar ligament
o
Collateral ligaments
o Measurement:
 Circumference compression.
o Movement power :
 Active and passive. (use the Gonue meter)
 Flexion
 Extension
 Pain in movement.
 Cripitation
o Special test:
 Stability tests:
 Valgus stress test
o
Holds the lateral aspect of the knee by one hand and
by the other hand above the ankle joint medially
push the leg laterally.

Edited By: Mohd Zahrani Hyperzahranism

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WWW.SMSO.CC Abdullah Husni

 Varus stress test:

o
Holds the medial aspect of the knee by one hand and
by the other hand above the ankle joint laterally
push the leg medially.
 Anterior drawer test:
o
Flex knee 90 o
o
Set on the foot
o
Put your hands on the knee with your thumbs on the
Tibial tubercle and fingers surround from back
o
Jerk the leg toward you.
o
Compare both legs
o
Repeat with 70o and compare both legs
 Posterior drawer test : ‫العكس‬
 Lachman test:
o
Relax knee in 15o flexion
o
One hand stabiles femur
o
The other hand try to left tibia forward
o
+ve = if there is anterior tibial movement
 McMurray test (for menical tire):
o
Put one hand on the joint line to fell any clicks.
 For medial meniscus:
 Flex the leg fully with external rotation of the
foot and also abduct the lower leg
 This complex movement will arise a click in
medial joint line → +ve test
 For lateral meniscus:
 Flex the leg fully with internal rotation of the
foot and also adduct the lower leg
 This complex movement will arise a click in
lateral joint line → +ve test

Edited By: Mohd Zahrani Hyperzahranism

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