The Knee History and Physical Exam

last authored: Oct 2009, David LaPierre and Susan Tyler
last reviewed:

 

 

Introduction

return to top

 

Expose both knees. Also remember that knee pain can be referred pain from the hip.

 

 

 

Inspection

(SEADS)

 

Examine knee in flexion and extension.


When patient is standing and walking, look for:

With patient sitting or laying, look for:

return to top

 

 

 

Palpation

 

(TEST CA)

bony landmarks:

joint:

effusion

soft tissue:

return to top

 

 

 

Range of Motion

ROM (scapulae and glenohumeral joint involvement)
Flexion (130 deg)
Extension (0 deg)
External rotation
Internal rotation

return to top

 

 

 

Special Tests

medial and collateral ligaments: hold leg with knee slightly flexed, apply medial and lateral stress

anterior and posterior cruciate (Drawer test): sit on foot, pull tibia forward (ACL), then backward (PCL)

medial and lateral menisci (McMurray's test): palpable clicking or pain suggests meniscal damage

Lachman’s test: More specific for ACL tear. Flex knee at 15 deg; stabilize thigh while other hand grasps tibia and pulls anteriorly. Anterior tibial movement of greater than 5 mm = ACL injury

return to top

 

 

 

Resources and References

return to top