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Physical Exam Knee
From WikiSM
Contents
Introduction
- Follows the IP-PASS examination methodology
- Inspection
- Palpation
- Passive Range of Motion
- Active Range of Motion
- Strength & Neurovascular
- Special Tests
Inspection
- Skin
- Color: erythema, ecchymosis, white, black
- Trophic changes (altered hair growth, sweat production)
- Scars
- Swelling
- Joint effusion
- Muscle tone: atrophy, hypertrophy
- Deformity: asymmetry, rotation, amputation
- Areas of emphasis for knee exam
- Are there any deformities present?
- Is there a joint effusion?
- What is the resting position of the knee (i.e. is it held in partial flexion or extension)
Palpation
- Palpate for
- Effusion
- Clicking
- Snapping
- Crepitus
- Tenderness
- Temperature
- Masses
- Areas of Emphasis
- Medial/ lateral femoral condyle
- Medial/ lateral joint line
- Medial/ lateral tibial plateau
- 4 poles of the patella
- Tibial tubercle
- Pes anserine
- Hamstrings posteriorly
- Fibular head
Range of Motion
- Knee
- Flexion: 120-130
- Extension: 0
Strength and Neurovascular
- Knee Extension : Quadriceps Femoris (Rectus Femoris, Vastus Lateralis, Vastus Medialis, Vastus Intermedius)
- Knee Flexion: Hamstrings (Biceps Femoris, Semitendinosus, Semimembranosus), Gracilis, Sartorius, Gastrocnemius, Popliteus
Neurovascular
- Sensory Nerves
- L1: Iliac crest, groin
- L2, L3: Anterior and inner thigh
- L4: Lateral thigh, anterior knee, medial leg
- L5: Lateral leg, dorsal foot
- S1: Posterior Leg
- S2: Plantar foot
- S3, S4: Perianal
- Dermatome
- Needs to be updated
- Reflexes
- Commonly Used
- Patellar (L3, L4)
- Achilles (S1, S2)
- Uncommonly Used
- Medial Hamstring (L5, S1)
- Lateral Hamstring (S1, S2)
- Posterior Tibial (L4, L5)
- Cremasteric (L1, L2)
- Anal wink/ bulbocavernous (S2)
- Myotomes:
- L2: Hip Adduction, Hip Flexion
- L3: Knee Extension, Hip Adduction, Hip Flexion
- L4: Knee Extension, Dorsiflexion
- L5: Hip Abduction, Hip Extension, Toe Dorsiflexion, Foot Inversion, Dorsiflexion
- S1 Foot Version, Plantarflexion
- S2: Toe Plantar Flexion
- S3: Bowel, bladder function
- S4: Bowel, bladder function
Special Tests
- Knee Effusion
- Iliotibial Band Syndrome
- Extensor Mechanism Injury
- Active Straight Leg Raise
- Patellar Tendonitis
- Popliteus Tendinopathy
- ACL Injury
- PCL Injury
- MCL Injury
- LCL Injury
- Meniscal Pathology
- Posterolateral Corner Injury
- Patellofemoral Pain Syndrome, Chondromalacia Patella, Patellar Instability
- Plica Syndrome
- Infrapatellar Fat Pad Impingement
- Patellar Instability
- Bakers Cyst
- Saphenous Nerve Entrapment
See Also
- Internal
- External
- Sports Medicine Review Knee Pain: https://www.sportsmedreview.com/by-joint/knee/
Created by:
John Kiel on 27 March 2021 13:41:28
Authors:
Last edited:
4 October 2022 15:42:59
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