ORTHOPEDIC KNEE EXAMINATION PERFORMA FOR MS, DNB, ORTHO PRACTICAL EXAM

KNEE EXAMINATION PROFORMA

Inspection

• Alignment
• Attitude
• Swelling/contours / abnormal shifts / prominence
• wasting
• scars/ sinuses
• patellar shape/size/position

Palpation

• Local temperature
• Local tenderness- patellar grate, retropatellar tenderness, fibular head, femoral & tibial condyles, tibial tuberosity
• Synovium thickening
• bony palpation-L/E femur, U/E Tibia & fibula
• effusion-patellar tap/cross fluctuation
• Patello-femoral joint -                                                  apprehension test for patellar subluxation,                         patellar tilt,                                                                       patellar grind
• Popliteal fossa examination-                                          swelling: pulsatile +      changes with flexion/extension +

Movements

• Flexion
• Extension
• active/passive
• lag/deformity/arc
• compare with opposite side

Measurements

• Length of femur & tibie
• thigh & calf girth
• Q angle
• intercondylar distance/ intermalleolar distance
• lateral thigh-leg angle
• Tibial torsion

Special Tests

Meniscus

• McMurray’s test
• Apley’s grinding test

ACL

• anterior drawer test
• Lachman test
• pivot shift test

PCL

• posterior drawer test
• sag sign

MCL and LCL

• varus and valgus stress test at 30 degrees
• alpeys distraction test

Other tests

• Neuro-vascular deficit- peroneal nerve palsy
• Lymph nodes- popliteal , inguinal
• Opposite knee, ipsilateral hip & ankle
• Gait
• Function-ambulation distance, walking, sitting, squatting,stairs