Skill Performance Evaluation: Musculoskeletal Examination; Lower Extremity (Hip, Knee, Ankle, Foot)

Directions: You will have 15 minutes to complete the skill*. All critical (C) steps and 80% of the noncritical steps
must be performed or verbalized. Special tests (S) will be performed if requested by the instructor.
*These skills are performed bilaterally. Start: End:
Performed Verbalized
Washes hands and dons appropriate personal protective equipment. C

Introduces self to patient using first and last name. Y/N

Notes general appearance and vital signs. Y/N

Inspection
1. Observe the gait Y/N Y/N

2. Inspect the lower extremities for symmetry, swelling, or deformity Y/N Y/N

Palpation
1. Bony landmarks, muscles, tendons, ligaments for swelling, tenderness, bogginess,
Y/N
enlargement
2. Hip: iliac crest, anterior- and posterior-superior iliac spine, greater trochanter, sacroiliac
Y/N Y/N
joint, trochanteric bursa
3. Knee: tibiofemoral joint, medial and lateral menisci, medial and lateral femoral condyles,
medial and lateral tibial plateaus, medial and lateral collateral ligaments, patellar tendon, tibial Y/N Y/N
tuberosity, suprapatellar and prepatellar bursae
4. Ankle and foot: anterior joint space, Achilles tendon, calcaneus, plantar fascia, medial and
Y/N Y/N
lateral malleoli, metatarsophalangeal joints, and grooves between heads of metatarsals
Assess Range of Motion (ROM)
1. Hips: flexion, extension, adduction, abduction, internal and external rotation Y/N Y/N

2. Knees: flexion, extension, internal and external rotation Y/N Y/N

3. Ankles: dorsiflexion and plantar flexion, inversion and eversion Y/N Y/N

4. Feet and toes: forefoot abduction and adduction, flexion and extension of toes Y/N Y/N

Special Tests
1. Knee tests for effusion: bulge and balloon signs S Y/N

2. Knee test for meniscus injury: McMurray S Y/N

3. Knee tests for ligamentous injuries: valgus/varus stress, anterior/posterior drawer; Lachman S Y/N

4. Ankle: anterior drawer S Y/N

All exams were performed with bilateral comparison. C

Adequate exposure was obtained for all inspection steps. C

Adequate draping was maintained for all steps. C

Evaluation: #Y = #C =
min. = 20/25 min. = 4
Comments on quality of performance: Needs remediation?

Y/N

Student: Evaluator: Date:

Developed by Albany Medical College, Center for Physician Assistant Studies | Bickley: Bates’ Guide to Physical Examination
and History Taking, Twelfth Edition. Copyright © 2017 Wolters Kluwer Health