Physical Examination of Knee

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Article Summary

Physical Examination of the Knee should include careful inspection of the knee, palpation for point tenderness, assessment of joint effusion, range-of-motion testing, evaluation of ligaments for injury or laxity, and assessment of the meniscus. We'll evaluate the ligaments on the inside and the outside of the knee. So we'll basically have the knee, drop it over the side of the table, flex it about 30...

Key Takeaways

  • This article explains Introduction in simple medical language.
  • This article explains Inspection in simple medical language.
  • This article explains Palpation in simple medical language.
  • This article explains Range of Motion in simple medical language.
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  • New weakness, severe pain, high fever, or symptoms after a serious injury.
  • Any symptom that feels urgent, unusual, or unsafe for the patient.
1

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Physical Examination of the Knee should include careful inspection of the knee, palpation for point pain when an area is touched or pressed. সহজ বাংলা: চাপ দিলে ব্যথা।" data-rx-term="tenderness" data-rx-definition="Tenderness means pain when an area is touched or pressed. সহজ বাংলা: চাপ দিলে ব্যথা।">tenderness, assessment of joint effusion, range-of-motion testing, evaluation of ligaments for injury or laxity, and assessment of the meniscus. We’ll evaluate the ligaments on the inside and the outside of the knee. So we’ll basically have the knee, drop it over the side of the table, flex it about 30 to 40 degrees and stress it outside and stress it inside. This tests the medial collateral ligament and the lateral collateral ligament.

Introduction

  • Follows the IP-PASS examination methodology
    • Inspection
    • Palpation
    • Passive Range of Motion
    • Active Range of Motion
    • Strength & Neurovascular
    • Special Tests

Inspection

  • Skin
    • Color: allergy, infection, or inflammation. সহজ বাংলা: চামড়া লাল হয়ে যাওয়া।" data-rx-term="erythema" data-rx-definition="Erythema means skin redness, often from irritation, allergy, infection, or inflammation. সহজ বাংলা: চামড়া লাল হয়ে যাওয়া।">erythema, ecchymosis, white, black
    • Trophic changes (altered hair growth, sweat production)
    • Scars
  • Swelling
  • Joint effusion
  • Muscle tone: atrophy, hypertrophy
  • Deformity: asymmetry, rotation, amputation
  • Areas of emphasis for knee exam
    • Are there any deformities present?
    • Is there a joint effusion?
    • What is the resting position of the knee (i.e. is it held in partial flexion or extension)

Palpation

  • Palpate for
    • Effusion
    • Clicking
    • Snapping
    • Crepitus
    • pain when an area is touched or pressed. সহজ বাংলা: চাপ দিলে ব্যথা।" data-rx-term="tenderness" data-rx-definition="Tenderness means pain when an area is touched or pressed. সহজ বাংলা: চাপ দিলে ব্যথা।">Tenderness
    • Temperature
    • Masses
  • Areas of Emphasis
    • Medial/ lateral femoral condyle
    • Medial/ lateral joint line
    • Medial/ lateral tibial plateau
    • 4 poles of the patella
    • Tibial tubercle
    • Pes anserine
    • Hamstrings posteriorly
    • Fibular head

Range of Motion

  • Knee
    • Flexion: 120-130
    • Extension: 0

Strength and Neurovascular

  • Knee Extension : Quadriceps Femoris (Rectus Femoris, Vastus Lateralis, Vastus Medialis, Vastus Intermedius)
  • Knee Flexion: Hamstrings (Biceps Femoris, Semitendinosus, Semimembranosus), Gracilis, Sartorius, Gastrocnemius, Popliteus

Neurovascular

  • Sensory Nerves
    • L1: Iliac crest, groin
    • L2, L3: Anterior and inner thigh
    • L4: Lateral thigh, anterior knee, medial leg
    • L5: Lateral leg, dorsal foot
    • S1: Posterior Leg
    • S2: Plantar foot
    • S3, S4: Perianal
  • Dermatome
    • Needs to be updated
  • Reflexes
    • Commonly Used
    • Patellar (L3, L4)
    • Achilles (S1, S2)
    • Uncommonly Used
    • Medial Hamstring (L5, S1)
    • Lateral Hamstring (S1, S2)
    • Posterior Tibial (L4, L5)
    • Cremasteric (L1, L2)
    • Anal wink/ bulbocavernous (S2)
  • Myotomes:
    • L2: Hip Adduction, Hip Flexion
    • L3: Knee Extension, Hip Adduction, Hip Flexion
    • L4: Knee Extension, Dorsiflexion
    • L5: Hip Abduction, Hip Extension, Toe Dorsiflexion, Foot Inversion, Dorsiflexion
    • S1 Foot Version, Plantarflexion
    • S2: Toe Plantar Flexion
    • S3: Bowel, bladder function
    • S4: Bowel, bladder function
  • Vascular:
    • Femoral Artery
    • Popliteal Artery
    • Dorsalis Pedis Artery
    • Posterior Tibial Artery

Special Tests

  • Knee Effusion
    • Ballottement Test
  • Iliotibial Band Syndrome
    • Obers Test
    • Nobles Test
    • Renne Test
  • Extensor Mechanism Injury
    • Active Straight Leg Raise
  • Patellar Tendonitis
    • Bassets Sign
  • Popliteus Tendinopathy
    • Garrick Test
  • ACL Injury
    • Anterior Drawer Test
    • Lachmans Test
    • Pivot Shift Test
    • Lever Test
  • PCL Injury
    • Posterior Drawer Test
    • Quadriceps Active Test
    • Posterior Sag Sign
  • MCL Injury
    • Valgus Stress Test
  • LCL Injury
    • Varus Stress Test
  • Meniscal Pathology
    • McMurrays Test
    • Apley Grind Test
    • Thessaly Test
    • Bounce Home Test
  • Posterolateral Corner Injury
    • Dial Test
    • Posterolateral Drawer Test
    • Posterolateral External Rotation Test
    • Reverse Pivot Shift Test
    • Varus Stress Test (Knee)
  • Patellofemoral Pain Syndrome, Chondromalacia Patella, Patellar Instability
    • Patellar Compression Test
    • Patellar Grind Test
    • Patellar Apprehension Test
    • Passive Patellar Glide
    • Patella Alta Test
    • Patellar Tilt Test
    • Squat Test
    • Vastus Medialis Coordination Test
    • Waldrens Test
    • Step Down Test
    • Lateral Step Down Test
  • Plica Syndrome
    • Hughstons Plica Test
    • Stutter Test
    • Plica Active Extension Test
    • Plica Flexion Test
    • [[Medial Patellar Plica Test]
  • Infrapatellar Fat Pad Impingement
    • Hoffas Test
  • Patellar Instability
    • Patellar J Sign
    • Patellar Glide Test
  • Bakers Cyst
    • Foucher Sign
    • Homan Sign
  • Saphenous Nerve Entrapment
    • Tinels Test
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Which doctor may help?

Orthopedic doctor, rheumatologist, or physiotherapist depending on cause.

What to tell the doctor

  • Write which joints hurt, swelling, morning stiffness duration, fever, injury, and walking difficulty.
  • Bring X-ray, uric acid, ESR/CRP, rheumatoid factor, or previous reports if available.

Questions to ask

  • Is this injury, osteoarthritis, rheumatoid arthritis, gout, infection, or another cause?
  • Which exercises, supports, or lifestyle changes are safe?
  • Do I need blood tests or X-ray?

Tests to discuss

  • Joint examination and range of motion
  • X-ray when chronic arthritis or injury is suspected
  • ESR/CRP, uric acid, rheumatoid tests when inflammatory arthritis is suspected

Avoid these mistakes

  • Do not ignore hot swollen joint with fever.
  • Avoid repeated steroid injections/tablets without a clear diagnosis and follow-up.

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This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Drink safe fluids and monitor temperature.
  • In dengue-prone areas, discuss CBC and platelet count when fever persists or warning signs appear.
  • Use tepid sponging for high fever discomfort; avoid ice-cold bathing.

OTC medicine safety

  • For fever, common fever medicine may be discussed with a clinician or pharmacist.
  • Avoid aspirin/ibuprofen-like medicines in suspected dengue unless a doctor says it is safe.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Fever with breathing difficulty, confusion, repeated vomiting, bleeding, severe weakness, stiff neck, or dehydration needs urgent care.
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Safe pathway to proper treatment

Patient care roadmap

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

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  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

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  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

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Emergency first: Severe chest pain, breathing trouble, unconsciousness, stroke signs, severe injury, heavy bleeding, or rapidly worsening symptoms need urgent local medical care now.

Frequently Asked Questions

Is this article a replacement for a doctor?

No. It is educational content only. Patients should consult a qualified clinician for diagnosis and treatment.

When should I seek urgent care?

Seek urgent care for severe symptoms, rapidly worsening condition, breathing difficulty, severe pain, neurological changes, or any emergency warning sign.

References

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