Preparation and Draping

• Wash your hands and introduce the examination to the patient
• Standing: Knees should be fully exposed. You will need to observe gait and to inspect the knees both front and back. This can be done before or after the supine exam
• Supine: Ensure the patient is draped so you can see both thighs fully but the groin and genital area are covered and will not become exposed with movement of the legs.

Starting Position

• Supine
• Draping

Inspection

Supine

• Asymmetry between the knees
  • Expose both sides → “I am going to repeat this exam on the other side”
• SEADS, Masses
  • Quadriceps atrophy
• Joint effusion:
  • look for fullness in the suprapatellar region;
  • look for loss of the medial fossa (filling in of the space just medial and inferior to the patella)

Palpation

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Temperature

• With the back of your fingers feel above, below and on the kneecap, comparing both sides. The kneecap should be cooler than the tissue above or below the knee. A warmer knee may indicate pathology on that side. </aside>

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Joint line tenderness

• Bend the patient’s knee with the foot flat on the bed
• Palpate the tibial tuberosity and upwards along the patellar tendon to find the joint line
• Feel along the joint line with your thumbs
• Each side of the joint should be palpated separately for tenderness. Watch patient’s face for pain/tenderness. </aside>

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Pulses and Neurological

• PP, DP
• Touch Sense </aside>

Special Test

Joint effusion