Knee exam

Observation

• Ecchymosis (bruise)? Surgical scars?
• Knee resting position
• Knee effusion with obscured landmarks
• Quadriceps muscle atrophy

Knee effusion tests

• patellar ballotment
• knee milking

Range of motion

• Normal flexion = 130 degrees
  • look for pain
  • do active vs passive ROM
• Normal extension = 10 degrees above horizontal

Anterior Cruciate Ligament (ACL) Stability Tests

• Lachman's Test (most sensitive)
• Anterior drawer sign

Posterior Cruciate Ligament (PCL) Tests

• Posterior drawer test
• PCL sag test

Collateral ligament evalutation

• Knee valgus stress test (Medial collateral ligament)
• Knee varus stress test (Lateral colalteral ligament)

Meniscus Evaluation

• McMurrays Test (external rotation and extension from full knee flexion for medial meniscal tear, internal rotation and extension for lateral mensicusus)
• Apley's compression test (grind home test)

Standing evaluation

• Balanced weight on each leg
• Genu varum or genu valgum deformity
• Gait analysis
• Hip, knee and ankle alignment

Other OSCE modules

Observed structured clinical examination

Acute Confusion - Acute Coronary Syndrome Orders - Anemia - Arterial Blood Gasses - Asthma - Blood Pressure - Chest pain - Chest XRay - CHF - Coma - COPD - Cranial Nerves - Diabetic History - Diabetic Foot - Dysphagia - EKGs - Gallbladder and Liver - Liver Disease - Gait and Balance - Headache - Hematemesis - Hypertension - Jugular Venous Pulses - Knee Exam - Lymph Nodes - Community Acquired Pneumonia - Parkinson Disease - Peripheral Arterial Insufficiency - Pneumonia Examination - Precordial Exam - STD's - Spleen - Swollen Leg Exam - Thyroid Exam - Upper vs Lower Motor Neuron Lesions - Urinary Incontinence