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Physical examination of the knee begins by observing the person's gait to assess for any abnormalities seen while walking. Gait assessment can be used to differentiate genuine knee pain or pain which referred from hip, lower back or the foot. A person can be asked to perform a duckwalk. This requires the person to squat and walk in that position.
A good examination of joint movement, in addition to helping the physical therapist diagnose the patient's functional loss, can provide an objective criteria to determine the effectiveness of a treatment program. The complete or partial movement of an articulation is called range of movement. The range of movement differs from one joint to another.
Place your hand over the knee and then the hip joints feeling for crepitus as the patient moves these joints. Now test internal rotation of the hip with the knee joint flexed to 90 degrees (moving the foot laterally with the knee flexed causes internal rotation of the hip joint - early OA causes pain and limitation of this movement).
The knee is flexed at 15 degrees with the patient supine. [2] The examiner should place one hand behind the tibia and the other grasping the patient's thigh. It is important that the examiner's thumb be on the tibial tuberosity. [3] The tibia is pulled forward to assess the amount of anterior motion of the tibia in comparison to the femur. An ...
The Thomas test is a physical examination test, named after the Welsh orthopaedic surgeon, Hugh Owen Thomas (1834–1891), to rule out hip flexion contracture (fixed partial flexion of the hip) and psoas syndrome (injury to the psoas muscle).
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The patient should be supine with the hips flexed to 45 degrees, the knees flexed to 90 degrees and the feet flat on table. The examiner positions himself by sitting on the examination table in front of the involved knee and grasping the tibia just below the joint line of the knee.
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