knee examination dr.kholoud al- zain
DESCRIPTION
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. - PowerPoint PPT PresentationTRANSCRIPT
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Knee Examination
Dr.Kholoud Al-Zain
Acknowledgment:Dr.Abdulaziz Alomar
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General MSK Physical Examination Principles for Lower Examination
• Exposure• Bilateral limb examination• Anterior and posterior • Gait• LLD• NV examination• Joint above and joint below
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Gait
• Antalgic gait
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Knee Examination
• Look (Inspection)• Feel (Palpation)• Move• Special tests
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Inspection (Look)
• Deformity• Scars• Swelling• Skin colour changes• Muscle wasting
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Muscle wasting
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Deformity Deformity
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Scars
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Localize Swelling
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Defuse swelling (Effusion)
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Feel (palpation)
• Temperature• Tenderness• Effusion
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Tenderness
• Soft tissue• Bony prominences • Joint line
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Surface anatomy
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Joint line palpation
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Effusion
Ballotment Milking
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MOVE
Active ROM Passive ROM
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ROM
• Flexion contracture• Extension lag
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Special tests
• Ligaments (stability):– ACL (Anterior Cruciate Ligament)– PCL (Posterior Cruciate Ligament)– MCL (Medial Collateral Ligament)– LCL (Lateral Collateral Ligament)
• meniscus• Patellofemoral joint
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ACL (anterior cruciate ligament)
Anterior drawer test• Excessive forward movement of the tibia on
the femur
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Lachman’s test• The most sensitive test
for ACL rupture• Anterior Translation and
end point (soft vs. hard)
ACL (anterior cruciate ligament)
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Pivot shift test:When positive, it is painfulIt needs experience to be
able to elicit it
ACL (anterior cruciate ligament)
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PCL (posterior cruciate ligament)
Posterior drawer test• excessive backward
movement of the tibia in relation to the femur.
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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.
PCL (posterior cruciate ligament)
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MCL
Full extension 15 degree flexion
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LCL
Full extension 15 degree of flextion
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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
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Patella apprehension test