Knee:

Inspection

• look for valgus deformity (ankles deviate away from midline), varus deformity (towards midline), fixed flexion deformity, scars, swelling, erythema, gait

Palpation

• palpate knee, behind knee (for bakers cyst) & around joint line (when knee bent) + assess joint temp
• bulge sign for effusion: milk fluid up & round patellar
• patellar tap: milk fluid downwards & tap patellar, this detects a larger effusion

Movement & special tests

• flex & extend with hand on knee to assess for crepitus (normal range = 0-130 degrees)
• ask patient to straight leg raise = a good test for quadriceps power & function
• cruciate ligaments: with knee flexed & foot flat on bed (sit next to patient’s foot to fix it’s position, so you have both hands free) pull tibia towards & then push away = anterior & posterior drawer tests
• collateral ligaments: hold/support knee at 20 degrees flexion, move ankle left then right whilst supporting just above thee knee (can also perform this by placing their foot/ankle under your arm pit & pushing the knee left then right)
• meniscal tests: mcmurray’s test is the most common = with one hand on foot flex knee to 90 degrees, place other hand on the lateral side of the knee & push knee medially (=valgus force), then extend & externally rotate the knee at the same time, pain +/- clicking indicates medial meniscal tear, for lateral tears push the knee laterally (=varus force) extend & internally rotate, N.B. you are unlikely to have to perform meniscal tests in your exam as they can cause pain