Knee orthopedic test

1. PRESENTATION ON ORTHOPEDIC TEST FOR
THE KNEE
By
Umofia Aniekan Imoh
2nd June, 2022.

2. Brush Test
Pt in supine with knee supported on
the table and slightly flexed. PT
places one hand below the joint line
on the medial surface of the patella
and strokes proximally with the
palm and fingers as far as the
suprapatellar pouch. The other
hand then strokes down the lateral
surface of the patella. (+) wave of
fluid just below the medial distal
border of the patella. Indicates knee
effusion.

3. Ballotable Patella
Pt in supine with the knee
extended on table. PT applies
a slight tap over the center of
the patella. (+) patella
appears to be floating
("dancing patella" sign).
Indicates retro-patellar
effusion

4. Clarke’s Test
Pt in supine with knee
extended on table. PT applies
slight posterior pressure with
the web space of their hand
over the superior pole of the
patella while PT instructs the
pt to contract the quadriceps
muscle. (+) pain upon
contraction.
Indicates patello-femoral
dysfunction.

5. Anterior Drawer Test
Pt in supine with the knee flexed to
90 degrees and the hip flexed to 45
degrees. PT stabilizes the lower leg
by sitting on the forefoot and grasps
the patient's proximal tibia with
both hands placing the thumbs on
the tibial plateau. PT administers an
anterior directed force to the tibia
on the femur. (+) excessive anterior
translation of the tibia on the femur
with a diminished or absent end-
point. Indicates ACL injury.

6. Posterior Drawer Test
Pt in supine with the knee flexed to
90 degrees and the hip flexed to 45
degrees. PT stabilizes the lower leg
by sitting on the forefoot and grasps
the patient's proximal tibia with
both hands placing the thumbs on
the tibial plateau. PT administers an
posterior directed force to the tibia
on the femur. (+) excessive posterior
translation of the tibia on the femur
with a diminished or absent end-
point. Indicates PCL injury.

7. Posterior Sag Sign
pt in supine with knee
flexed 90 deg. & hip
flexed 45 deg. PT
observes position. (+)
tibia "sags" posterior.
Indicates PCL injury.

8. Valgus Stress Test
Pt in supine with entire LE
supported and knee flexed to 20-30
deg. PT places one hand on medial
surface of ankle and other hand on
lateral surface of knee. PT applies
valgus force to the knee with distal
hand. (+) excess valgus movement
and/or pain. Indicates MCL sprain.
Note: a (+) test with knee in full
extension may be indicative of
damage to MCL, PCL, posterior
oblique ligament, posteromedial
capsule

9. Varus Stress Test
pt in supine with entire LE
supported and knee flexed 2030
deg. PT places one hand on lateral
surface of ankle and other hand on
medial surface of knee. PT applies
varus force to knee with distal hand.
(+) excess varus movement and/or
pain. Indicates LCL sprain. NOTE: a
(+) test with knee in full extension
may be indicative of damage to LCL,
PCL, poterolateral capsule

10. Apley’s Compression
Test
Pt in prone with knee flexed 90 deg.
PT stabilizes femur with PT's hand.
PT passively distracts the knee joint
then slowly rotates tibia internally
and externally then apply a
compressive force through tibia
while continuing the rotation of the
tibia. (+) pain/clicking or decreased
motion during compression
indicates meniscal dysfunction. (+)
pain/clicking or decreased motion
during distraction indicates
ligamentous dysfunction.

11. McMurray Test
Pt in supine with knee in full
extension. PT grasps distal leg with
one hand and palpates knee joint
line with other. PT medially rotates
tibia and extends knee. Repeat
same while laterally rotating tibia.
(+) pain &/or click over joint line.
Indicates dysfunction in lateral
meniscus with passive IR of tibia
and medial meniscus with ER of
tibia