📌 𝐅𝐨𝐥𝐥𝐨𝐰 𝐨𝐧 𝐈𝐧𝐬𝐭𝐚𝐠𝐫𝐚𝐦:- / drgbhanuprakash
Knee Joint Examination - OSCE Orthopedics : Clinical essentials
Knee pain and other knee-related complaints are a common reason for visits to primary care clinics and emergency departments. An effective and efficient evaluation of the patient with knee-related complaints depends upon an understanding of the knee's anatomy and function, and the proper performance of an appropriately focused physical examination.
●Elements and approach to the physical examination - Examination of the knee involves inspection, palpation, assessment for a joint effusion, testing of motion, testing of motor function and strength, assessment of joint stability, and possibly special tests to detect specific conditions. The examination should be performed systematically. It is often useful to compare affected and unaffected joints; it is essential to use patient demographics and the history to focus the functional examination.
●Inspection - While inspecting the knee and lower extremity, the clinician should assess the following: gait, swelling, ecchymosis and other signs of injury, muscle atrophy, alignment, and skin changes (eg, scars, rash).
●Palpation - Palpation of the knee should include the anterior joint line (including lateral and medial aspects), anterior knee off the joint line, posterior knee, bursae, and skin temperature. Focal tenderness at a specific site usually indicates damage to a specific structure in that location. Diffuse tenderness along the joint line is most commonly due to irritation of the synovial membrane caused by a degenerative, inflammatory, or infectious process, but localized injuries such as meniscal and collateral ligament tears may also cause diffuse tenderness. The clinician must determine whether a joint effusion is present.
●Range of motion - If the patient has full, active range of motion, it is not usually necessary to assess passive motion. Common reasons for diminished active but intact passive motion include motor nerve damage, excessive pain, and structural disruption of the muscle tendon unit. Diminished passive motion is often due to a mechanical block (eg, torn meniscus).
●Neurovascular assessment, motor function, and joint stability - Assessments of neurovascular and motor function and of joint stability are fundamental parts of the knee examination.
●Special tests - Provocative tests are used to detect specific knee pathology, but the sensitivity and specificity of such maneuvers is often limited. We suggest performing only those special tests most likely to be relevant, as determined by the history, initial examination findings, and the test characteristics (if known) of the special test in question.
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