Physical examination of the knee is performed by accessing temperature, fluid, tendon pathology, cartilage pathology, and laxity. No single clinical examination element, or combination of such elements, reliably detects meniscal injury. The diagnostic accuracy of anterior drawer ad sign, lachman test and the pivot shift test for anterior cruciate ligament injury and mcmurray test for medial and lateral meniscus is varied with. Knee examination corner stone comparative analysis translation or rotation end point compliance. Range of motion have the patient move to a supine and relaxed position.
Nicholas a piantanida md, nicole t yedlinsky md, in the sports medicine resource manual, 2008. Knee orthopedic tests university of western states. Look also for muscle atrophy of the quadriceps, hamstrings and gastrocnemius. It is a procedure by which the knee is systemically rotated to identify where tears in the cartilage called the meniscus may have occurred or developed. The examination of the knee university of nevada, reno. While palpating the joint line, apply a valgus force to the knee, while simultaneously externally rotating and extending the knee completely. A tear in the meniscus may cause a pedunculated tag of the meniscus which may become jammed between the joint surfaces. Mcmurrays test was used to assess meniscal integrity.
Anterior drawer test supine hip45 deg knee 90 deg stabilize foot ensure tibia is not sagging behind otherwise false positive result not possible in acute painful knee 15. The latter three steps are often remembered with the saying look, feel, move. The test therefore seems to be of limited value in current clinical practice. If the itband is tight, the patient will have difficulty adducting the leg beyond the midline and may experience pain at the lateral knee. Common knee tests in orthopedic examination the following is a list of the many common tests used by physical therapists and other orthopedicorthopaedic practitioners when examining the knee. Mcmurrays test is used to determine the presence of a meniscal tear within the. We studied the validity of mcmurrays test for a torn meniscus in 93 patients. In the past, mcmurrays test is used to assess for meniscal damage. Obers test the patient lies with the unaffected side down and the unaffected hip and knee at a 90 degree angle. The mcmurray test for torn meniscus can provide the clinician with useful information as to the whether a torn medial or lateral meniscus is responsible for the patients knee pain.
A standardized approach basic approach to the knee. As koa is influenced by knee biomechanics, tests of ligamentous integrity helped determine whether alterations in ligaments were directly affecting symptoms. These variations constitute different tests with different statistical performance and should not be confused with the original. Pdf clinical assessment of meniscal pathology in the knee has proven difficult due to the wide number of tests available and variations in their. Stress the knee joint by medially and laterally moving the foot. He has a 1a lachman and a normal posterior drawer test. Examination of theof the knee foundation for orthopaedic. In this video, i perform the mcmurrays test of the knee. Mcmurray test is performed with the patient supine. Motor quads l2,3,4 semimembraneous s1,l5 biceps femoris s1 pf df ii. The purpose of this resource is to have a web based, readily accessible learning tool for medical students and residents to learn and improve musculoskeletal exam of the knee. Anatomy and physical examination of the knee menisci.
The view from the side detects any recurvatum or lack of complete extension. The examiner stands on the side of the affected knee and places one hand on the heel and another along the medial aspect of the knee, providing a valgus force. The mcmurray test also known as the mcmurray circumduction test is used to detect internal tears in the knee joint. Common knee tests in orthopedic examination physical. The physical examination of the knee ligaments consists of testing of the lateral ligaments with the varus or valgus stress test 3334. There are also various claims regarding the sensitivity and specificity of his test. Pdf validity of the mcmurrays test and modified versions of the. Current concept open access clinical examination of the. Basic approach knee examination osu center for continuing. The mcmurray test is best for ruling in meniscal pathology. The steinmann i test is carried out with the knee flexed at 90 degrees and a sudden external rotatory force is applied on the tibia to test the medial meniscus.
The decision to scope the knee should not be solely taken on the results of clinical tests. Clinical examination of the knee sussex msk partnership. Lachmans test varus and valgus stress tests complete the examination thank the patient and allow them to redress to complete the examination. Rotation most sensitive test for acl rupture useful in painful knee door step effect of menisci. Osteopathic knee exam assess for tenderness along medial and lateral joint lines of the knee apley compression test is used to assess meniscal integrity. Many commonly performed orthopedic tests for the knee have not been. Youll be expected to pick up the relevant clinical signs using your examination skills.
By contrast, anterior tears to the front of the knee are not easily diagnosed and may require an mri or. This is another of the most well known and most used special tests in orthopedics. On examination, he has a knee effusion and tenderness laterally. There are many variations described of exactly how to do his test and what the findings actually mean. The mcmurray test is a commonly used test in orthopedic examinations to test for damagetears to the meniscus. Kai demonstrates the mcmurray test for meniscus damage. Mcmurray s test is used to determine the presence of a meniscal tear within the knee technique. The mcmurray test is especially useful for detecting tears in the posterior back aspect of the knee. To perform the mcmurray test the doctor holds the knee with one hand and the bottom of foot with other hand. For knee pain, how predictive is physical examination for. The tests will eventually have links to descriptions of the tests as well as video demonstrations.
To perform the mcmurray test for torn meniscus the examiner has the patient assume the supine position on the examination table with the knee maximally flexed. The apleys grind test also called apleys compression test or apley test is used to evaluate knee meniscus injury procedure. The knee examination, in medicine and physiotherapy, is performed as part of a physical examination, or when a patient presents with knee pain or a history that suggests a pathology of the knee joint the exam includes several parts. Pdf mcmurrays test and joint line tenderness for medial. This knee examination osce guide provides a clear step by step approach to examining the knee, with an included video demonstration. When it is done, leg is pushed up while pressing on the knee and turning the leg. Clinicians frequently use the results of clinical diagnostic tests to make decisions concerning patients. Hold the knee up and fully flexed, with one hand over the knee joint itself and the other on the sole of that foot. Mcmurrays test, is an orthopaedic clinical test for evaluating the knee joint for tears in the meniscus cartilage procedure.
Pain or a click is a positive test, confirming meniscal damage. Detailed examination of the joints is usually not included in the routine medical examination. What is the biomechanical or manual therapy assessment is there joint. Common testsmaneuvers include the noble test, ober test, lachman test, and mcmurray s test. Place the tested leg back in maximal hip and knee flexion. Meniscal palpation tests in mcmurray test thekneeisflexedwhilethelegis externally rotated, palpating the joint line with a finger. Feel free to like and subscribe to our channel and head over to our website. Mcmurrays test orthopaedic examination of knee medisavvy. Lachman test supine knee 15 deg flexion slight ext. Clinicians frequently use the results of clinical diagnostic tests to make. Physical examination findings and their relationship with. Central tears are sometimes detected with this maneuver. Physical examination of the knee, in the sports medicine resource manual. For the posterior drawer test,the patient assumes a supine position with knees flexed to 90 degrees.
The mcmurray test, also known as the mcmurray circumduction test is used to evaluate individuals for tears in the meniscus of the knee. Mcmurrays test tested knee surgery, sports traumatology. This test is intended for diagnosis of meniscus tears. The clinical test results were compared with arthroscopic andor arthrotomy findings as reference.
1204 1014 628 1522 647 402 1542 121 1459 454 81 806 564 225 376 221 553 358 390 148 1225 1015 947 1100 1239 798 707 1440 556 165 889 294