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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.
Most commonly, varus and valgus stress to the knee is added. These variations constitute different tests with different statistical performance and should not be confused with the original. According to some sources, the sensitivity of the McMurray test for medial meniscus tears is 53% and the specificity is 59%.
In order to perform the test, the patient lies prone (face-down) on an examination table and flexes their knee to a ninety degree angle. The examiner then places his or her own knee across the posterior aspect of the patient's thigh. The tibia is then compressed onto the knee joint while being externally rotated. If this maneuver produces pain ...
While maintaining internal rotation, a valgus force is applied to the knee while it is slowly flexed. If the tibia's position on the femur reduces as the knee is flexed in the range of 30 to 40 degrees or if there is an anterior subluxation felt during extension the test is positive for instability. Pivot-shift is not straightforward to perform.
The Ober test is used in physical examination to identify tightness of the iliotibial band (iliotibial band syndrome). During the test, the patient lies on his/her side with the unaffected leg on the bottom with their shoulder and pelvis in line. The lower hip and knee can be in a flexed position to take out any lordosis of the lumbar spine. [1]
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). Illustration of the Thomas test.
The patellar tap is a technique used in an examination of the knee to test for knee effusion or "water-on-the-knee". [1] With the examinee lying on their back, the examiner extends the knee and presses the area above the kneecap with the palm of one hand. This pushes fluid under the kneecap and lifts it.
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 ...