Knee Assessment

Scan Exam
w over pressure

Hip

Flexion, Exention Abduction, Adduction Internal, External (leg can be straight if hurts knee to bend, or at 90) Plantarexion, Dorsiexion Inversion, Eversion genu varus (2 ngers normal) genu valgum (together) patella tracking- baja (down), alta (up), squinting-retroversion=patella medially rotated, grasshopper (out) down and up kinetic chain genu recurvatum (hyper extension) Bakers cyst popliteal fossa, folds pes planus (helbing sign inward), cavus (achilles outward) muscular imbalance- hip exors/extensors, lateral/medial rotators are they limbing? can they stand on both legs? weight bearing? balance? color, texture, scars, bruising, deformity Dermatome lat-med on top of thigh ant thigh to knee to the oor web 1-2nd toe lateral foot medial calf or normal or Flexion Extension Internal External Rotation Patella Plantarexion passive resisted Myotome hip exion knee ext Knee soles together big toe up evert foot knee ex 5/5 2+ normal 0-135 0- -15
abnormal end feels: -sudden/hard (mm spasm/guard) -capsular (soft- edema, hard-frozen) -boney (osteophytes) -empty (pain limits- bursitis) -springy block (meniscal)

Foot and Ankle Observations

bumps, bruises scars, redness rash, psoriasis moles, skin tags swelling, trauma

Anteriorly

Lateral Posterior

Gait General Neurological Nerve Root L2 *test bilaterally L3 L4 L5 S1 S2 Grading Movement Testing * most painful last * passive w overpressure Active Passive Resisted Grade 5/5

Reex
Reex Response: 0=absent 1+=diminished 2+=normal 3+=brisk 4+=non sustained clonus, very brisk, clonus (rhythmic movement in response to reex) 5+=sustained clonus * map out peripheral * sharp dull

Achilles Heel

tissue stretch/ approx tissue stretch *knee at 90 & dorsiexion *inf/sup, med/lat glide gastroc crosses knee

Palpation

Bony

patella, patellafemoral joint, femoral condyles head bula (shift A to P- cant invert/evert foot), tibial tuberosity (osgood schlatters, patella tendonitis) joint line (medial and lateral)

location size, shape, tone,

Palpation

Knee Assessment
location size, shape, tone, edema, temp trigger points

Soft Tissue

MCL, LCL medial/lateral meniscus (joint lines) patellar tendon, pes anserine tendon (bursitis, tendonitis) quads, hamstrings, ITB, gastroc, popliteus (V), popliteal pulse (found medial head of gastrocs), fossa Bakers cyst, DVT (heat, painful) 1. 2. 3. 4. 5. 6. 7. 1. 2. 3. 4. 5. 6. Brush Wipe Test- intra articular effusion Valgus Stress Test- MCL Varus Stress Test- LCL Lachmans Test- ACL Anterior Drawer Test- ACL Posterior Drawer Test- PCL Posterior Sag Sign- PCL McMurrays (medial)- medial meniscus McMurrays (lateral)- lateral meniscus Thessaly Test- meniscus Apleys Compression- meniscus Apleys Distraction- collateral ligaments Bounce Home Test- meniscus

Special Tests

Effusion Tests

Meniscal Tests

Notes
* trauma: always test ACL
swelling: 1. 0-2 hours: ACL rupture 2. 6-24hours: meniscal 3. no swelling: MCL sprain

Condition OA of knee

Description degenerative disease of the knee joint- more in ppl over 40- more women MCL/LCL, ACL/PCL knee pain/swelling, worse when knee bears more weight, complaint is joint locking, when px unable to straighten leg fully- clicking caused by injury (fall) when knee is straightened, chronic overuse due to faulty biomechanics- symptoms- knee does not fully extend, or blocked up on exion of the knee swelling in popliteal space inammatory of medial knee at bursa- pain when climbing stairs

Sprain/rupture Meniscal damage Sprain Popliteus

Bakers cysts Pes Anserine Bursitis Patella Tendonitis

frequent with jumping- overuse from repetitive overloading of the extensor mechanism of the knee