JoVE Science Education

Physical Examinations III

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Knee Exam

Genel Bakış

Source: Robert E. Sallis, MD. Kaiser Permanente, Fontana, California, USA

The knee is a hinged joint that connects the femur with the tibia. It is the largest joint in the body, and due to its location in the middle of the lower leg, it is subjected to a variety of traumatic and degenerative forces. Examination of the knee can be quite complex, owing to the fact it is an inherently unstable joint held together by various ligaments and supported by menisci, which act as shock absorbers and increase the contact area of the joint. In addition, the patella lies in front of the knee, acting as a fulcrum to allow the forceful extension of the knee needed for running and kicking. As the largest sesamoid bone in the body, the knee is a common source of pain related to trauma or overuse.

When examining the knee, it is important to remove enough clothing so that the entire thigh, knee, and lower leg are exposed. The exam begins with inspection and palpation of key anatomic landmarks, followed by an assessment of the patient's range of motion (ROM). The knee exam continues with tests for ligament or meniscus injury and special testing for patellofemoral dysfunction and dislocation of the patella. The opposite knee should be used as the standard to evaluate the injured knee, provided it has not been previously injured.

Prosedür

1. Inspection

  1. Ask the patient to walk, and observe for limping and pain.
  2. Carefully compare both knees and look for the following:
    1. Swelling or effusion: Suggested when the injured knee is visibly larger than the uninvolved knee. Swelling is defined as enlargement of the knee outside of the joint and is due to bleeding or excessive fluid in the soft tissues around the knee. Effusion, on the other hand, is due to bleeding or excessive fluid inside the knee joint. Palpating for effusion is o

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Başvuru ve Özet

Examination of the knee is best done following a stepwise approach with the patient in sitting and supine positions. The patient should be observed for limping or pain while walking into and out of the exam room. It is important to have the patient remove enough clothing so that the surface anatomy of the knee can be seen and compared to the uninvolved side. The knee exam should begin with inspection, looking for asymmetry between the involved and uninvolved knee, noting whether the involved knee is larger (indicating

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