Osce: How to examine the knee
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The document provides guidance on examining a patient's knees, outlining steps to introduce yourself, ask about pain, get permission, wash hands, visually inspect the knees, assess gait, feel the knees, check range of motion through movement, perform special tests, conclude the examination, and offer additional assessment or treatment as needed. The examination focuses on systematically evaluating the knees for issues like injuries, swelling, range of motion, and neurological function.
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Osce: How to examine the knee
- 1. OSCE: How to examine the knee Dr A Barai MBBS, MRCS, MSc (Critical care) Registrar, Emergency Medicine
- 2. Introduce yourself “Hello, I am Dr Barai. I am the Registrar in the Emergency Department. I would like to examine your knees if that is alright with you”
- 3. Ask about pain “Do you have any pain anywhere? Do you like to have some painkillers before I examine you?”
- 4. Take permission “During the examination I would like you to expose your legs upto the groin if that is alright with you. During the examination I may have to touch your knees and do some manoeuvres if that is alright with you? May I proceed please?”
- 5. Hand washing Tell the patient and the examiner that before you examine the patient you would like to wash your hands
- 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. Gait • Ask the patient to walk a few steps if they are happy to do that. • Look for antalgic gait
- 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. Move • Active flexion and extension • Passive flexion and extension • Comment on the range of movement
- 10. Special tests • Lachman test • Varus and valgus test • McMurray’s test
- 11. Conclude • Thank the patient. • Offer help in dressing him up.
- 12. To the examiner I would like to examine the full neurovascular status of the lower limb and joint above eg the hip joint and joint below eg ankle. I would like to give him analgesia, crutches and would also like to have a xray of the knee to see if there is any bony injury
- 13. Finish Thank both the examiner and the patient before leaving.
- 14. Answer sheet
- 15. Tips to pass this OSCE station • Practise • Practise • Practise
- 16. Any comments or suggestions? Please let me know: drbarai@gmail.com