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Knee Examination

A 13-step examination covering inspection, squat screening, palpation, movement, effusion and named tests.

Musculoskeletal · Self-paced

Step 1. Introduction

  1. Hand hygiene

    Hand wash/rub

  2. Introduce yourself

    Introduce self

  3. Explain the purpose

    Explain purpose

  4. Consent

    Obtain consent

  5. Ask about pain

    Ask if patient has pain in either knee

Step 2. Inspection (Look)

  1. Exposure

    Adequate exposure, shoes removed

  2. Stance inspection

    Inspect in stance from front, side and behind

  3. Visible features

    Skin changes, muscle wasting, spasms, swellings, deformity

  4. Posture and symmetry

    Posture and symmetry

  5. Gait

    Gait

  6. Report findings

    Report findings correctly

Step 3. Squat Tests (Screening)

  1. Squat test

    Squat test

  2. Ege's test

    Ege's test

  3. Support

    Provide support as needed

  4. Report findings

    Report findings correctly

Step 4. Palpation (Feel)

  1. Instructions and position

    Clear instructions; correct patient position

  2. Temperature

    Assess temperature

  3. Bony landmarks

    Bony landmarks

  4. Joint line

    Joint line

  5. Muscle bulk

    Muscle bulk

  6. Popliteal fossa

    Popliteal fossa

  7. Tendons and ligaments

    Tendons and ligaments

  8. Commentary

    Commentary to examiner while palpating

  9. Tenderness and bilateral assessment

    Ask about tenderness; assess bilaterally

  10. Report findings

    Report findings correctly

Step 5. Move (Active then Passive)

  1. Active range of motion

    Active ROM

  2. Passive range of motion

    Passive ROM

  3. Crepitus and tenderness

    Palpate for crepitus; ask about tenderness

  4. Report findings

    Report findings correctly

Step 6. Effusion Tests

  1. Swipe/bulge test

    Swipe/bulge test

  2. Patellar tap/ballottement test

    Patellar tap/ballottement test

  3. Compare sides

    Compare both sides

  4. Report findings

    Report findings correctly

Step 7. Patellar Apprehension Test

  1. Previous dislocation

    Ask about previous dislocation of either knee

  2. Patellar apprehension test

    Perform patellar apprehension test correctly

  3. Compare sides

    Compare both sides

  4. Report findings

    Report findings correctly

Step 8. Sag Sign (PCL)

  1. Technique

    Appropriate technique

  2. Report findings

    Report findings correctly

Step 9. Anterior and Posterior Drawer Tests (ACL & PCL)

  1. Technique

    Appropriate technique

  2. Compare sides

    Compare both sides

  3. Report findings

    Report findings correctly

Step 10. Lachman's Test (ACL)

  1. Technique

    Appropriate technique

  2. Compare sides

    Compare both sides

  3. Report findings

    Report findings correctly

Step 11. Collateral Ligament Stress Tests (Valgus – MCL, Varus – LCL)

  1. Technique

    Appropriate technique

  2. Compare sides

    Compare both sides

  3. Report findings

    Report findings correctly

Step 12. McMurray's Test with Apley Grind (Menisci)

  1. McMurray's and Apley grind

    McMurray's (lateral and medial menisci, specifically testing medial) with Apley grind (medial and lateral)

  2. Technique

    Appropriate technique

  3. Compare sides

    Compare both sides

  4. Report findings

    Report findings correctly

Step 13. Conclusion

  1. Thank the patient

    Thank patient and indicate they may redress

  2. Further examination

    Indicate further examination of hip and ankle to complete examination

  3. Hand hygiene

    Hand wash/rub

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