Physical Examination of the Knee

Exam Overview

A dispatch knee examination is always done for a knee complaint. Both of your knees will be checked, and the results for the hurt knee will be compared to those of the goodly knee. Your sophisticate will besides check that the nerves and blood vessels are intact. Your doctor of the church will :

• Inspect your knee visually for redness,
  swelling, deformity, or skin changes.
• Feel your knee (palpation)
  for warmth or coolness, swelling, tenderness, blood flow, and
  sensation.
• Test your knee’s range of motion and listen for sounds.
  In a passive test, your doctor will move your leg and knee joint. In an active
  test, you will use your muscles to move your leg and knee joint. At the same
  time, your doctor will listen for popping, grinding, or clicking
  sounds.
• Check your

  knee ligaments

  Reading: Physical Examination of the Knee

  , which stabilize the knee. Tests
  include:

  • The valgus and varus tests, which
    check the
    medial
    and

    lateral
    collateral ligaments. In these tests, while
    you lie on the examining table, your doctor places one hand on your knee joint
    and the other on your ankle and moves your leg side to side.

  • The
    posterior drawer test, which checks the

    posterior cruciate ligament
    . In this test, you lie on the table with your knee
    bent at a 90-degree angle and your foot flat on the table. Your doctor will put
    his or her hands around the top of your leg just below your knee and push straight back on your leg.

  • The Lachman test, which checks the

    anterior cruciate ligament
    (ACL). In this test, while you lie on the table, your
    doctor will slightly bend your knee and hold your thigh with one hand. With the
    other hand, he or she will hold the upper part of your calf and pull forward.
    The Lachman test diagnoses a complete ACL tear.

  • The anterior drawer test, which checks the ACL. In this test, you lie on the table with your knee
    bent at a 90-degree angle and your foot flat on the table. Your doctor will put
    his or her hands around the top of your leg just below your knee and pull straight back on your leg.
  • A pivot shift test, which checks the ACL. In this test, the leg
    is extended and your doctor holds your calf with one hand while twisting the
    knee and pushing toward the body. It is often done just before a knee

    arthroscopy
    and after

    anesthesia
    has completely relaxed the muscles.

A McMurray test may be done if your sophisticate suspects a problem with the menisci based on your medical history and the above examination. In this test, while you lie on the table, your doctor holds your stifle and the penetrate of your foot. He or she then pushes your leg up ( bending your knee ) while turning the peg and pressing on the stifle. If there is pain and the legal or feeling of a suction stop, the meniscus may be damaged. Arthrometric testing of the knee may besides be done. In this test, your doctor will use an instrument to measure the relax of your knee. This test is specially useful in people whose pain or physical size makes a physical examination difficult. An arthrometer has two detector pads and a pressure handle that allows your doctor to put pull on the stifle. The instrument is strapped on to your lower leg so that the detector pads are placed on the knee crown and the belittled bump just below it ( tibial nodule ). Your doctor then measures coerce by pulling or pushing on the pressure manage. Your examination may besides include early tests to assess the degree of the wound and to identify damage to other parts of the knee.

Why It Is Done

A complete physical examination of the knee is always done for a knee complaint, whether the complaint is from a recent or sudden ( acute ) wound or from durable or perennial ( chronic ) symptoms .

Results

In general, in a convention stifle examination :

• The knee has its natural
  strength.
• The knee is not tender when touched.
• Both
  knees look and move the same way.
• There are no signs of fluid in or
  around the knee joint.
• The knee and leg move normally when the
  ligaments are examined.
• There is no abnormal clicking, popping, or
  grinding when knee structures are moved or stressed.
• The toes are
  pink and warm, and there is no numbness in the lower leg or foot.

If any of these findings are not true-for exercise, the knee is tender-you may have a knee wound. But the results of a knee examination vary depending on whether the examination is for a sudden injury to the stifle or for long-run symptoms and besides depending on how long it has been since the injury occurred. An abnormal finding does not always mean that your knee is injured. Your sophisticate will use the results of the examination, plus your medical history, to make a diagnosis .

What To Think About

These tests provide the best information if there is little or no knee swelling, you are able to relax, and your sophisticate is able to move your stifle and leg freely. If this is not the shell, it may be unmanageable to accurately check your knee. If your stifle is red, hot, or very swell, a stifle joint aspiration ( arthrocentesis ) may be done, which involves removing fluid from the knee joint. This is done to :

• Help relieve pain and pressure, which may make
  the physical exam easier and make you more comfortable.
• Check joint
  fluid for possible infection or inflammation.
• See if there is blood
  in the joint fluid, which may indicate a tear in a ligament or
  cartilage.
• See if there are drops of fat, which may indicate a
  broken bone.

local anesthetic may be injected after ambition to reduce pain and make the examination easier. If you are going to have arthroscopy, the knee may be examined in the function room before the routine, while you are under general or spinal anesthesia anesthesia. Complete the
medical test information form (PDF)

(What is a
PDF
document?)
to help you prepare for this test.

Credits

ByHealthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP – hand brake Medicine
Adam Husney, MD – family Medicine
Specialist Medical Reviewer Freddie H. Fu, MD – orthopedic Surgery

• Top of Page

writer : Healthwise staff
medical revue : William H. Blahd, Jr., MD, FACEP – Emergency Medicine & Adam Husney, MD – Family Medicine & Freddie H. Fu, MD – orthopedic surgery