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Chapter 9 - Examination of the Knee

Published online by Cambridge University Press:  22 April 2022

By
Jeevan Chandrasenan ,
Derek Bickerstaff  and
Fazal Ali
Edited by
Fazal Ali  and
Nick Harris
Fazal Ali
Affiliation:
Chesterfield Royal Hospital
Nick Harris
Affiliation:
Spire Hospital, Leeds
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Summary

Examination of the knee joint begins with standing the patient, then asking them to walk. Look for any lurch and observe the foot and patella progression angles. Next ask the patient to sit with their legs hanging over the couch. Observe the patella height and tracking. Then palpate for an effusion and for areas of tenderness. After this, examine the cruciate and collateral ligaments. Depending on the findings, so far further special tests would be a dial test for the posterolateral corner, meniscal stimulation tests or patellofemoral tests. Included in the chapter is clinical evaluation of the acutely injured knee in the child.

Keywords

kneevalgusvaruslurchpatellaanterior cruciate ligamentposterior cruciate ligamentcollateral ligament
Type
Chapter
Information
Orthopaedic Examination Techniques
A Practical Guide
 , pp. 153 - 171
Publisher: Cambridge University Press
Print publication year: 2022

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References

Maffuli, N, Binfield, PM, King, JB, Good, CJ. Acute haemarthrosis of the knee in athletes. A prospective study of 106 cases. J Bone Joint Surg Br 1993;75(6):945–949.Google Scholar
Simonian, PT, Fealy, S, Hidaka, C, O’Brien, SJ, Warren, RF. Anterior cruciate ligament injury and patella dislocation: a report of nine cases. Arthroscopy 1998;14(1):80–84.CrossRefGoogle ScholarPubMed
Flandrey, F, Hughston, JC, McCann, SB, Kurtz, DM. Diagnostic features of diffuse pigmented villonodular synovitis of the knee. Clin Orthop 1994;298:212–220.Google Scholar
Torg, JS, Conrad, W, Kalen, V. Clinical diagnosis of anterior cruciate ligament instability in athletes. Am J Sports Med 1976;4(2):84–93.Google Scholar
Draper, DO, Schulthies, SS. Examiner proficiency in performing the anterior draw and Lachman tests. J Orthop Sports Phys Ther 1995;22(6):263–266.CrossRefGoogle Scholar
Galway, HR, MacIntosh, DL. The lateral pivot shift: a symptom and sign of anterior cruciate ligament instability. Clin Orthop 1980;147:45–50.CrossRefGoogle Scholar
Bach, BR Jr, Warren, RF, Wickiewicz, TL. The pivot shift phenomenon: results and a description of a modified clinical test for anterior cruciate ligament instability. Am J Sports Med 1988;16(6):571–576.CrossRefGoogle Scholar
Nielsen, S, Rasmusson, O, Oveson, J, Andersen, K. Rotatory instability of cadaver knees after transection of collateral ligaments and capsule. Arch Orthop Trauma Surg 1984;103(3):165–169.CrossRefGoogle ScholarPubMed
Reider, B. The Orthopaedic Physical Exam, 2nd ed. Philadelphia: Elsevier Saunders, 2005.Google Scholar
Bae, JH, Choi, IC, Suh, SW, et al. Evaluation of the reliability of the Dial test for posterolateral rotator instability: a cadaveric study using an isotonic rotation machine. Arthroscopy 2008 May;24(5):593–598.CrossRefGoogle ScholarPubMed
Karachalios, T, Hantes, M, Zibis, AH, et al. Diagnostic accuracy of a new clinical test (the Thessaly test) for early detection of meniscal tears. J Bone Joint Surg 2005;87A(5):955–962.CrossRefGoogle Scholar
Solomon, L, Warwick, D, Nayagam, S. Apley’s System of Orthopaedics and Fractures, 8th ed. London: Arnold, 2001.Google Scholar
Dodds, AL, Halewood, C Gupte, CM, Williams, A, Amis, AA. The anterolateral ligament: anatomy, length changes and association with the Segond fracture. Bone Joint J 2014;56 -B:325–331.CrossRefGoogle Scholar
DeFranco, MJ, Bach, BR. Current concepts review. A comprehensive review of partial anterior cruciate ligament tears. J Bone Joint Surg Am 2009;91:198–208.CrossRefGoogle Scholar
Rubenstein, RA, Shelbourne, KD, McCarroll, JR, VanMeter, CD, Rettig, AC. The accuracy of the clinical examination in the setting of posterior cruciate ligament injuries. Am J Sports Med 1994;22(4):550–557.Google Scholar
Dold, AP, Swensen, S, Straus, E, Alaia, M. The posteromedial corner of the knee: anatomy, pathology and management strategies. J Am Acad Orthop Surg 2017 Nov;25(11):752–761.Google Scholar
Larson, RL. Physical examination in the diagnosis of rotatory instability. Clin Orthop Relat Res 1983;172:38–44.CrossRefGoogle Scholar
Ardern, CL, Ekås, GR, Grindem, H, et al. 2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries. Br J Sports Med 2018;52(7):422–438.CrossRefGoogle ScholarPubMed
Kocher, MS, DiCanzio, J, Zurakowski, D, et al. Diagnostic performance of clinical examination and selective magnetic resonance imaging in the evaluation of intraarticular knee disorders in children and adolescents. Am J Sport Med 2001;29:292–296.CrossRefGoogle ScholarPubMed

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