Knee examination

Jump to navigation Jump to search
Knee examination
Knee Extension

WikiDoc Resources for Knee examination

Articles

Most recent articles on Knee examination

Most cited articles on Knee examination

Review articles on Knee examination

Articles on Knee examination in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Knee examination

Images of Knee examination

Photos of Knee examination

Podcasts & MP3s on Knee examination

Videos on Knee examination

Evidence Based Medicine

Cochrane Collaboration on Knee examination

Bandolier on Knee examination

TRIP on Knee examination

Clinical Trials

Ongoing Trials on Knee examination at Clinical Trials.gov

Trial results on Knee examination

Clinical Trials on Knee examination at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Knee examination

NICE Guidance on Knee examination

NHS PRODIGY Guidance

FDA on Knee examination

CDC on Knee examination

Books

Books on Knee examination

News

Knee examination in the news

Be alerted to news on Knee examination

News trends on Knee examination

Commentary

Blogs on Knee examination

Definitions

Definitions of Knee examination

Patient Resources / Community

Patient resources on Knee examination

Discussion groups on Knee examination

Patient Handouts on Knee examination

Directions to Hospitals Treating Knee examination

Risk calculators and risk factors for Knee examination

Healthcare Provider Resources

Symptoms of Knee examination

Causes & Risk Factors for Knee examination

Diagnostic studies for Knee examination

Treatment of Knee examination

Continuing Medical Education (CME)

CME Programs on Knee examination

International

Knee examination en Espanol

Knee examination en Francais

Business

Knee examination in the Marketplace

Patents on Knee examination

Experimental / Informatics

List of terms related to Knee examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


The knee examination, in medicine, is performed as part of a physical examination, or when a patient presents with knee pain or a history that suggests a pathology of the knee joint.

The exam includes several parts:

  • position/lighting/draping
  • inspection
  • palpation
  • motion

The latter three steps are often remembered with the saying look, feel, move.

Position/lighting/draping

Position - for most of the exam the patient should be supine and the bed or examination table should be flat. The patient's hands should remain at his or her sides with the head resting on a pillow. The knees and hips should be in the anatomical position (knee extend, hip neither flexed or extend).

Lighting - adjusted so that it is ideal.

Draping - both of the patient's knees should be exposed so that the quadriceps muscles can be assessed.

Video: Understanding Knee Pain

{{#ev:youtube|BVWApDz6zmQ}}

Inspection done while the patient is standing

The knee should be examined for:

Inspection done while supine

The knee should be examined for:

Palpation

An inflamed knee exhibits tumor (swelling), rubor (redness), calor (heat), dolor (pain). Swelling and redness should be evident by inspection. Pain is gained by history and heat by palpation.

  • Temperature change - using the back of the hand one should feel the temperature of the knee below the patella, over the patella, and above the patella. Normally, the patella is cool relative to above and below the knee. A complete exam involves comparing the knees to one another.
  • joint line tenderness - this is done by flexing the knee and palpating the joint line with the thumb.
  • Effusions, test for
    • Patellar tap - useful for large effusions
    • Ballottement - defined as a palpatory technique for detecting or examining a floating object in the body
    • Bulge sign - useful for smaller effusions

Motion

The patient should be asked to move their knee. Full range of motion is 0-135 degrees. If the patient has full range of motion and can move their knee on their own it is not necessary to move the knee passively.

  • examination of crepitus - clicking of the joint with motion

Ligament tests

Knee Extension (L 2, 3, 4):

Have the seated patient steadily press their lower extremity into your hand against resistance. Test each leg separately. Extension is mediated by the quadriceps muscle group, which is innervated by the femoral nerve.

(Image courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, California)

Knee flexion (L 5; S 1, 2):

Have the patient rest prone. Then have them pull their heel up and off the table against resistance. Each leg is tested separately. Flexion is mediated by the hamstring muscle group, via branches of the sciatic nerve.

(Image courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, California)

Explanation of Knee Examination

Video 1

{{#ev:youtube|_StElDL5A64}}

Video 2

{{#ev:youtube|fNUGyNYVhqE}}

Video 3

{{#ev:youtube|NpSu6m9_mpA}}

See also

External Links

Template:WikiDoc Sources