(English captions by Trisha Paul from the University of Michigan)
To ensure a thorough assessment, it is best to perform the musculoskeletal exam of the knee in a
systematic way.
The following is a suggested order of exam that incorporates many of the common
techniques used for evaluating the injuries.
Begin the exam with the patient in the standing position.
Look for evidence of gross deformity, muscular atrophy,
symmetry of the patellar alignment,
evidence of varus or valgas positioning of the knee
or presence of pes planus and pes cavus of the foot.
From a posterior view, observe for more than two toes laterally also called the too
many toes sign.
This can indicate an over-pronated foot or an abducted fore foot.
Have the patient perform a toe raise and evaluate the heel position.
Normally the heel should change from a neutral to a varus position.
Next observe the gait,
looking for an antalgic gate
or excessive pronation or supination.
Next, evaluate active range of motion.
If pain or limitation exists, repeat the range of motion passively. In a seated
position, test for knee extension.
In this position, also observe
patellar tracking.
and internal and external rotation of the hip
which can help identify referred knee pain caused by hip pathology.
Also in this seated position, palpate anatomic landmarks for tenderness.
Palpate the distal quadriceps, quadriceps tendon,
the patella,
and patellar tendon,
the tibial tuberosity,
and the fat pads beneath the patella.
On the medial side,
palpate the medial collateral ligament,
the medial joint line,
the pes anserine bursa,
and on the lateral side, the lateral collateral ligament,
the lateral joint line,
and the fibular head.
Posteriorly palpate the popliteal fossa and the distal hamstrings.