1. Knee Examination Dr.Kholoud Al-Zain Acknowledgment: Dr.Abdulaziz Alomar

2. General MSK Physical Examination Principles for Lower Examination Exposure Bilateral limb examination Anterior and posterior Gait LLD NV examination Joint above and joint below

3. Gait Antalgic gait

4. Gait Antalgic gait Stiff knee gait Flexed knee gait

5. Knee Examination Look (Inspection) Feel (Palpation) Move Special tests

6. Inspection (Look) Deformity Scars Swelling Skin colour changes Muscle wasting

9. Deformity

10. Scars

11. Localize Swelling

12. Defuse swelling (Effusion)

13. Feel (palpation) Temperature Tenderness Effusion

14. Tenderness Soft tissue Bony prominences Joint line

15. Surface anatomy

16. Joint line palpation

17. Effusion BallotmentMilking

18. MOVE Active ROMPassive ROM

19. ROM Flexion contracture Extension lag

20. Special tests Ligaments (stability): – ACL (Anterior Cruciate Ligament) – PCL (Posterior Cruciate Ligament) – MCL (Medial Collateral Ligament) – LCL (Lateral Collateral Ligament) meniscus Patellofemoral joint

21. ACL (anterior cruciate ligament) Anterior drawer test Excessive forward movement of the tibia on the femur

22. Lachman’s test The most sensitive test for ACL rupture Anterior Translation and end point (soft vs. hard) ACL (anterior cruciate ligament)

23. Pivot shift test: When positive, it is painful It needs experience to be able to elicit it ACL (anterior cruciate ligament)

24. PCL (posterior cruciate ligament) Posterior drawer test excessive backward movement of the tibia in relation to the femur.

25. 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)

26. MCL Full extension15 degree flexion

27. LCL Full extension15 degree of flextion

28. 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

29. Patella apprehension test