Knee examination dr kholoud al zain
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Knee Examination Dr.Kholoud Al- Zain PowerPoint PPT Presentation


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Knee Examination Dr.Kholoud Al- Zain. Acknowledgment: Dr. Abdulaziz Alomar. General MSK Physical Examination P rinciples for Lower Examination. Exposure Bilateral limb examination Anterior and posterior Gait LLD NV examination Joint above and joint below. Gait . Antalgic gait.

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Knee Examination Dr.Kholoud Al- Zain

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Knee ExaminationDr.Kholoud Al-Zain

Acknowledgment:

Dr.Abdulaziz Alomar


General MSK Physical Examination Principles for Lower Examination

  • Exposure

  • Bilateral limb examination

  • Anterior and posterior

  • Gait

  • LLD

  • NV examination

  • Joint above and joint below


Gait

  • Antalgicgait


Knee Examination

  • Look (Inspection)

  • Feel (Palpation)

  • Move

  • Special tests


Inspection (Look)

  • Deformity

  • Scars

  • Swelling

  • Skin colour changes

  • Muscle wasting


Muscle wasting


Deformity

Deformity


Scars


Localize Swelling


Defuse swelling (Effusion)


Feel (palpation)

  • Temperature

  • Tenderness

  • Effusion


Tenderness

  • Soft tissue

  • Bony prominences

  • Joint line


Surface anatomy


Joint line palpation


Effusion

Ballotment

Milking


MOVE

Active ROM

Passive ROM


ROM

  • Flexion contracture

  • Extension lag


Special tests

  • Ligaments (stability):

    • ACL (Anterior Cruciate Ligament)

    • PCL (Posterior Cruciate Ligament)

    • MCL (Medial Collateral Ligament)

    • LCL (Lateral Collateral Ligament)

  • meniscus

  • Patellofemoral joint


ACL (anterior cruciate ligament)

Anterior drawer test

  • Excessive forward movement of the tibia on the femur


ACL (anterior cruciate ligament)

Lachman’s test

  • The most sensitive test for ACL rupture

  • Anterior Translation and end point (soft vs. hard)


ACL (anterior cruciate ligament)

Pivot shift test:

When positive, it is painful

It needs experience to be able to elicit it


PCL (posterior cruciate ligament)

Posterior drawer test

  • excessive backward movement of the tibia in relation to the femur.


PCL (posterior cruciate ligament)

Sagging sign:

  • compare both knees in 90 degrees of flexion.

  • In the injured knee the proximal tibia is displaced backwards compared to the other side.


MCL

Full extension

15 degree flexion


LCL

Full extension

15 degree of flextion


Meniscus

  • Joint line tenderness:

    • Tenderness in the medial joint line (medial meniscus)

    • Tenderness in the lateral joint line (lateral meniscus)

  • McMurrey’s test for medial and lateral meniscus


Patella apprehension test


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