Knee Exam
Knee Exam
Please assess the student performing a knee exam
Student's Email:

GENERAL - Observe the student doing the following:

Wash hands
       
Introduces self and exam to patient
           
Appropriate draping of patient

Expose both legs with patient lying flat, ensuring the groin remains draped

               

GAIT INSPECTION - The student should comment on the following:

Comments on gait abnormalities

Ex: Antalgic gait

               
Examines for bony abnormalities

Ex: valgus(knock knee)/varus deformity(bow legged), genu recurvatum(hyperextension)

               

INSPECTION - The student should comment on the following:

Patient's general appearance

Ex: In pain, well, not well

               
Masses, scars, lesions

Ex: Scars from previous knee surgery, evidence of trauma

               
Joint swelling

Compares both legs for signs of effusion

               
Erythema

Examines for erythema bilaterally

               
Skin Changes
               
Muscle atrophy/hypertrophy

Compare both sides for symmetry

               
Bony abnormalities
               
Inspects popliteal fossa

Ex: Baker's cyst

               

PALPATION - Observe the student performing the following manoeuvers:

Temperature of knee

Normal = cooler than rest of leg, Abnormal = warm

               
Palpate joint line for tenderness

Best with knee flexed with foot on the bed

               

TESTS FOR EFFUSION - Observe the student performing the following manoeuvers:

Bulge sign

Positive sign - fluid bulge in medial compartment

               
Patellar tap

Positive sign - hear a 'click' or feel the patella contact the femoral condyles

               
Ballottement

Positive sign - feel fluid in medial and lateral compartments

               

RANGE OF MOTION - Observe the student performing the following manoeuvers:

Active range of motion

Normal = 120o flexion, full extension

               
Passive range of motion

Simultatously palpate for crepitus

               

SPECIAL TESTS - Observe the student performing the following manoeuvers:

Anterior drawer test

For ACL stability

               
Posterior drawer test

For PCL stability

               
Test for MCL stability

Applies a valgus strain

               
Test for LCL stability

Applies a varus strain

               

GLOBAL RATING SCALES - Please rate the student on their overall performance:

Understands rational of manoeuvers and findings
                   
Organized approach
                   
Sensitivity toward patient concerns and comfort during the examination