Osce: How to examine the knee

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Here the author demonstrates how to examine the knee joint during an OSCE exam. Good luck!

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  • This is a common station in the MBBS, MRCS. MCEM and FCEM exams.
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Osce: How to examine the knee

  1. 1. OSCE: How to examine the knee Dr A Barai MBBS, MRCS, MSc (Critical care) Registrar, Emergency Medicine
  2. 2. Introduce yourself“Hello, I am Dr Barai. I am the Registrar in the Emergency Department. I would like toexamine your knees if that is alright with you”
  3. 3. Ask about pain“Do you have any painanywhere? Do you like tohave some painkillersbefore I examine you?”
  4. 4. Take permission“During the examination I would likeyou to expose your legs upto thegroin if that is alright with you.During the examination I may haveto touch your knees and do somemanoeuvres if that is alright withyou? May I proceed please?”
  5. 5. Hand washingTell the patient and the examiner that beforeyou examine the patient you would like towash your hands
  6. 6. Look• Ask the patient to stand up on the floor.• Look from front, side and behind• Comment on: - Skin condition: bruises, laceration - Scar mark - Muscle wasting - Deformity - Discharging sinus - Asymmetry
  7. 7. Gait• Ask the patient to walk a few steps if they are happy to do that.• Look for antalgic gait
  8. 8. Feel• Ask the patient to lie on the couch• Feel for temperature• Feel quads• Bulge test• Patellar tap test• Bony tenderness over patella, medial and lateral joint lines
  9. 9. Move• Active flexion and extension• Passive flexion and extension• Comment on the range of movement
  10. 10. Special tests• Lachman test• Varus and valgus test• McMurray’s test
  11. 11. Conclude• Thank the patient.• Offer help in dressing him up.
  12. 12. To the examinerI would like to examine the fullneurovascular status of the lower limband joint above eg the hip joint andjoint below eg ankle.I would like to give him analgesia,crutches and would also like to have axray of the knee to see if there is anybony injury
  13. 13. FinishThank both the examiner and the patientbefore leaving.
  14. 14. Answer sheet
  15. 15. Tips to pass this OSCE station • Practise • Practise • Practise
  16. 16. Any comments or suggestions? Please let me know: drbarai@gmail.com

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