Case 1 – Knee Injury

Tim Milligan Musculoskeletal

You are seeing Sarah Tseng, a 21 year old female in the Emergency Department. She comes in complaining of severe left knee pain after she fell while running. Perform a focused physical examination.

Physical Examination

Inspection

  • Examines both knee joints for SEADS (swelling, erythema, muscle atrophy, deformity, skin changes)
  • Comments on presence of valgus/varus deformity
  • States that the hips and ankles should be examined as well

Palpation

  • Palpates knees for crepitus, warmth, and effusion.
  • Palpates along left joint-line for tenderness
  • Palpates for Baker’s cysts
  • Tests passive range of motion for effected knee

Tests for Effusion

  • Examines for Bulge Sign
  • Uses fluctuation to assess for effusion
  • Tests for ballottement

Range of Motion/Gait

  • Assesses patient’s gait
  • Assesses active range of motion for both knees

Stability

  • Assesses for LCL and MCL damage
  • Assesses for ACL damage using Anterior Drawer Sign
  • Assesses for PCL damage using Posterior Drawer Sign

Special Tests

  • Assesses for meniscal tears using McMurray Test
Case 1 – Knee Injury