Basic Examination of the Knee

General Inspection

• Fully expose legs
• Malalignment of legs - valgus, varus.
• Swelling, redness
  
• Scars
• Back of knees

Effusion

• Warmth of knees with back of hand
• Milk bursa, prevent refilling
  
• Patella tap
• If negative, milk smaller effusions, medially and upwards first.

Palpation

• Fully extend leg
• Tibial tuberosity
• Patellar tendon
• Margins of patella
• Quadriceps tendon
• Partially flex knee
• Tenderness of medial and lateral joint margins?
• If quadriceps wasting suspected, measure 10cm circumference above superior patellar margin

Movement

• Fully extend knee - hyperextension?
• Heel towards buttocks
• Push slightly further
• Passively extend knee, feel for crepitus.

Stability

• Medial Collateral Ligament - Partial flexion, pull tibia laterally
• Lateral Collateral Ligament - Partial flexion, push tibia medially
• Anterior Cruciate Ligament - Perch on foot, pull tibia anteriorly
• Posterior Cruciate Ligament - Perche on foot, push tibia posteriorly

Other

• Contralateral knee
• Hip joint above
• GAIT