Orthopaedic PE
Knee Examination
Side examined
1LookInspection
Gait
Normal gait
Antalgic gait
Varus thrust
Valgus thrust
Trendelenburg +ve
Walking aid
Alignment & deformity
Normal alignment
Varus deformity
Valgus deformity
Flexion deformity
Recurvatum
Increased Q-angle
Limb shortening
Swelling, skin & scars
No swelling
Effusion
Diffuse swelling
Prepatellar swelling
Popliteal swelling
Bruising
Erythema
Scar / previous surgery
Arthroscopy portals
Anterior midline scar (TKR)
Transverse scar (patellectomy)
Muscle bulk & patella
Quadriceps wasting
Patella alta
Patella baja
Lateral patellar tilt
Squinting patellae
Crepitus on tracking
J-sign
2FeelPalpation
Effusion knee extended
No effusion
Bulge test +ve (small)
Patellar tap +ve (moderate)
Large effusion
Warmth
Joint line & structures 90° flexion
No tenderness
Medial joint line tenderness
Lateral joint line tenderness
Posteromedial tenderness
Patellar tenderness
Tibial tubercle tenderness
Fibular head tenderness
MCL tenderness
LCL tenderness
Patella tendon tenderness
Fat pad tenderness
Bassett's sign +ve
Popliteal fossa mass
3MoveRange of motion
PE
PF
AE
AF
0°40°80°120°160°
0 – 130
Full active ROM · passive = active
Active (AE / AF)
Passive (PE / PF)
Movement quality
Crepitus
Hyperextension / recurvatum
Pain at end of flexion
SLR
4Ligament stability
Collateral ligaments
MCL
LCL
Cruciate ligaments
Posterior sag
Lachman
Anterior drawer
Posterior drawer
Pivot shift
Quads active
Posterolateral corner
Dial test 30°
Dial test 90°
+ve at 30° only = isolated PLC · +ve at 30° & 90° = combined PCL + PLC
PL drawer
ER recurvatum
Reverse pivot shift
Posteromedial corner
PM drawer
Valgus at 0°
AM rotation (AMRI)
5Meniscal tests
McMurray
Thessaly
Apley grind
Childress (squat)
Wilson's (OCD)
6Patellofemoral
Rotational profile
Normal rotational profile
Increased femoral anteversion
External tibial torsion
Miserable malalignment
Beighton's score
Glide & tracking
Patellar maltracking
Lateral retinaculum tight (<1 quadrant)
Medial retinaculum lax (>2 quadrants)
Provocation
Patellar apprehension
Clarke's test
7Neurovascular
Distal NV intact
Reduced quadriceps power
Reduced hamstring power
Common peroneal nerve deficit
DP pulse absent
PT pulse absent
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