A good knee exam starts with obtaining a good history.
- How did the pain begin? Sudden or gradual?
- Did the patient feel a pop?
- Did it occur while running? Twisting? When decelerating? Changing directions?
- What hurts now? What actions make it better or worse?
Of course, if there is concern for infection then there are further questions to ask.
My knee exam will be focused based on the history obtained, but I also tend to always perform most of the tests posted below every time. I develop a suspicion of the injury based on the history and mechanism of injury. Future posts will likely include more on this.
First observe the knee. Notice any clues like deformities or discoloration, and ask about severity of pain and/or any numbness. If these are present then the patient needs to be seen by a higher level of care for sure. Or, if the patient does not have full ROM then they need to be seen by a higher level of care. Do not miss a quad tendon tear or similar. Ensure the patient can fully extend the knee.
No, my intent is to help with the minor injuries in which no infection suspected, the pain is gradual, there has been no trauma, and the pain is not significant.
Below is a quick video on the basic anatomy of the knee.
Before we get into the academics of the knee, I think it is important to familiarize yourself on how to perform an adequate exam. Try to get a Doc, PA, Physical Therapist, PTA, or Athletic trainer to show you these also and allow you to practice. They can also go over the mechanisms of injury with you. In the meantime, you can obtain mental reps and save time by watching these videos.
Videos on the Special Tests for the Knee
Future posts will have more info. I am recruiting Physical Therapists and Athletic Trainers to assist me in this as well. Stay tuned.
All content is intended to be educational only. Medics should operate under the supervision of a medical provider and abide by all local laws while stateside. Medics should only practice at the level credentialed, and only at the level allowed. This content is not intended to treat or give a substitution for any credentialed provider. Content is intended to aid in a deployed prolonged care setting. Take guidance from your leaders. Utilize these posts as preparation and as a supplement to your provider’s direction and teaching.