Assessment of Knee joint

1. Saurab Sharma,
MPT
Knee Joint Assessment
Lecture 4
Subjective examination
Objective examination
Observation
Palpation
Range of motion
Muscle length
Muscle strength
Reflex

2. Knee Joint Assessment
Subjective Assessment
Demographic data
Chief complaint
History of present illness

3. Objectives of knee assessment
At the end of the day, students will be able to:
 Understand the need of taking consent for
assessment
 Identify and ask relevant history question in knee
injuries/ pain
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4. Assessing a knee joint
Components of the assessment include
 Focused history
 Attentive physical examination and
 Thoughtfully ordered tests/studies
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5. Subjective Assessment

6. Demographic data
 Name
 Age
 Gender
 Dominance
 Address
 Occupation
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7. Chief complaint
In patient’s own word
 Pain
 Swelling: immediate, delayed
 Giving way
 Locking
 Deformity
 Functional difficulty
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8. History of present illness:
 Onset of Pain
 Date of injury or when symptoms started
 Gradual/ sudden
 Progression: getting better, getting worse, no
change
 Location of pain
 Anterior
 Medial
 Lateral
 Posterior
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9. History of present illness:
Mechanism of Injury -helps predict injured
structure
 Contact or noncontact injury?
 If contact, what part of the knee was
contacted?
 Anterior blow?
 Valgus force? (common)
 Varus force?
 Was foot of affected knee planted on the
ground? (Closed vs open chain injury)9

10. History of present illness:
 Bony avulsion  Slow developing force might
 Ligament tear Rapidly developing force
 MCL injury Valgus force
 LCL injury  Varus force
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11. History of present illness:
ACL injury
 Common in weight bearing, slight flexion and rotation in
either directions
 Anterior translatory force on proximal tibia
 Hyperextension injury
 Hyperflexion in bulky lower extremity muscles
Meniscal injury
 Twisting force (injury with rotation of the tibia) in weight
bearing with slightly flexed knee
 Medial meniscus more commonly injured than lateral
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12. History of present illness:
 PCL injury
 Posterior translation of Tibia
 Pretibial trauma (Dashboard trauma)
 Hyper flexion (in thin individual)
 Hyperextension (second ligament to be injured after
ACL)
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13. History of present illness:
 These forces may cause injury to more than one
structure and same structure may be damaged with
various other kinds of mechanism of injury
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14. History of present illness:
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15. History of present illness:
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16. History of present illness:
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17. History of present illness:
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18. History of present illness:
Any clicking or pop sound during injury?
 Indicates ligament tear (mainly ACL) in knee
joint
Any “give way” or “catch”?
 give way= instability
 Catch (lock)= meniscal injury
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19. History of present illness:
 History of Swelling?
 Was the swelling immediate or delayed?
 Synovial swelling takes 8-24 hours to
develop
 Haemarthrosis  Immediate swelling
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20. History of present illness:
 Site of swelling?
 Area of swelling?
 Localized swelling Extracapsular injury
 Generalized swelling Intracapsular injury
 Inflammed bursae?
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21. History of present illness (HOPI):
 History of type of shoes patient normally
uses?
 Flat shoes?
 High heels?
 Duration of usage of shoes?
 Functional ability of the patient?
 Any disability in running, climbing stairs etc21

22. History of present illness (HOPI):
Sports specific history:
 Total duration of play
 Total practice/training session
 Exercise protocol- warm up/ cool down
 Competition
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23. Summary:
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24. Plan for next class
 Pain assessment
 Observation
 Prerequisites:
 Pain assessment
 Observation
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