2. REVIEW OF KNEE ANATOMY
The knee is called a pivot joint, as along with Flexion and
extension as principle movement around this joint, it also has
some rotary component.
The knee is one of the most frequently injured joints, because of
It’s anatomical structure.
Exposure to external forces.
Functional demands placed on it.
3. STRUCTURES AROUND KNEE
Can be divided into
A. Osseous structures.
B. Extra articular structures.
a. Extra articular tendinous structures
b. Extra articular ligamentous
structures.
C. Intra articular structures.
5. EXTRAARTICULAR STRUCTURES
The important extra articular structures supporting and
influencing the function of this joint are
The synovium.
Joint capsule.
Collateral ligaments.
Musculotendinous units that span the joint. ( also known as “extra
articular tendinous structures of knee joint”
9. KNEE CONDITIONS
Injury and mechanical derangement.
Congenital and developmental abnormalities.
Infection and inflammation.
Arthritis and rheumatic disorders.
Metabolic and endocrine disorders.
Tumours and lesions that mimic them.
Neurological disorders and muscle weakness.
10. HISTORY TAKING
PATIENT DETAILS CHIEF COMPLAINTS
HISTORY OF PRESENT ILLNESS PAST HISTORY
FAMILY HISTORY PERSONAL HISTORY
TREATMENT HISTORY NEGATIVE HISTORY
12. PAIN
Site Time and mode of onset
Severity or Intensity Character or Nature
Progression Referred pain
Aggravating factors Relieving factors
Any diurnal variation Any seasonal variation
13. PAIN
The extent of reference is governed by a number of factors.
The depth of the structure beneath the skin.
The position of the structure within the dermatome.
The severity of the lesion
15. SWELLING
Site Shape Size
First notice
Associated Symptoms
•Pain
•Pressure
•Neurological
•Vascular
•Articular
Progression
Any other swelling Reducibility
Any discharge
•If present
•Duration
•Regular or intermittent
•Character of discharge
16. DEFORMITY
Site
Associated Symptoms
• Neurological
• Vascular
• Articular
Amount of
disability
Time of Onset
• Congenital
• Developmental
• Acquired
Correctability
• Completely correctable
• Partially correctable
• Incorrectable
20. LOSS OF FUNCTION
Mode of onset
• Sudden
• Gradual
Duration
• Congenital
• Chronic
• Acute
Involved region
and function(s)
Progression
Associated
features
28. REGIONAL EXAMINATION
• InspectionLOOK
• PalpationFEEL
• Strength TestingMOVE
• Shortening or Lengthening
• Range of Motion
• Regional measurements
MEASURE
• Depends upon specific region in considerationSPECIAL TESTS
29. PHYSICAL EXAM - GENERAL
Develop a standard routine
Alleviate the patient's fears
Adequate exposure - bilateral
Compare both sides
30. EXAMINATION OF THE KNEE
Observe the gait and posture.
Observe the patient in standing and lying on couch
Observe the patient from front, side and back.
Look for any evidence of shortening.
31. INSPECTION
Any obvious deformity
Any compensatory mechanism
Gross shortening
Muscle wasting
Any swelling
Any scar
•Active sinus
•Healed sinus
•Scars of old surgery
35. RANGE OF MOTION (ROM)
Evaluate active ROM
If movement limited by pain, weakness, or tightness, assist
passively
Evaluate bilaterally for comparison