Home > Rheumatology > Examination

Examining the knee

Finding	Diagnosis
High-velocity collision Inability to immediately bear weight "Pop" occurred with injury	Fracture
Cut or pivot mechanism of injury Knee "gave way" Inability to continue participation "Pop" felt or heard with injury	ACL tear
Blow to proximal tibia Less instability than ACL tear	PCL tear
Squat/kneel associated with a twist Clicking Locking Pain with rotational movement	Meniscal tear
Occupational or recreational repetitive movement	Overuse syndrome
Fever, chills Intravenous drug use Lack of traumatic injury Recent sexual encounter History of abnormal joint	Infectious arthritis
Night pain Fevers Night sweats Unintentional weight loss	Tumour

Knee radiographs in acute injury are required only for patients with any of the following findings:

Age 55 years or older
Isolated tenderness of the patella (no bone tenderness of the knee other than the patella).
Tenderness at the head of the fibula
Inability to flex the knee to 90 degrees
Inability to bear weight (four steps) both immediately and in the emergency department (unable to transfer weight twice onto each lower limb regardless of limping)

Inspection of the knee
Palpation of knee
- superficial anatomy
Assessment of active and passive range of motion
Assessment for crepitation
Assessment of the integrity of the anterior cruciate ligament
- Anterior drawer test
- Lachman test
Assessment of the integrity of the Posterior Cruciate Ligament
- Posterior drawer test
- Sag test
Assessment of the integrity of the Collateral Ligaments
- Medial Collateral Ligament -Valgus stress test
- Lateral Collateral Ligament-Varus stress test
Assessment of the Menisci
- McMurray test
- Apley Compression test