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  • Chris' Corner
  • Jim's Corner
    • Orthopedic Blog
  • Special Tests
    • Cervical Spine >
      • Alar Ligament Test
      • Bakody's Sign
      • Cervical Distraction Test
      • Cervical Rotation Lateral Flexion Test
      • Craniocervical Flexion Test (CCFT)
      • Deep Neck Flexor Endurance Test
      • Posterior-Anterior Segmental Mobility
      • Segmental Mobility
      • Sharp-Purser Test
      • Spurling's Maneuver
      • Transverse Ligament Test
      • ULNT - Median
      • ULNT - Radial
      • ULNT - Ulnar
      • Vertebral Artery Test
    • Thoracic Spine >
      • Adam's Forward Bend Test
      • Passive Neck Flexion Test
      • Thoracic Compression Test
      • Thoracic Distraction Test
      • Thoracic Foraminal Closure Test
    • Lumbar Spine/Sacroiliac Joint >
      • Active Sit-Up Test
      • Alternate Gillet Test
      • Crossed Straight Leg Raise Test
      • Extensor Endurance Test
      • FABER Test
      • Fortin's Sign
      • Gaenslen Test
      • Gillet Test
      • Gower's Sign
      • Lumbar Quadrant Test
      • POSH Test
      • Posteroanterior Mobility
      • Prone Knee Bend Test
      • Prone Instability Test
      • Resisted Abduction Test
      • Sacral Clearing Test
      • Seated Forward Flexion Test
      • SIJ Compression/Distraction Test
      • Slump Test
      • Sphinx Test
      • Spine Rotators & Multifidus Test
      • Squish Test
      • Standing Forward Flexion Test
      • Straight Leg Raise Test
      • Supine to Long Sit Test
    • Shoulder >
      • Active Compression Test
      • Anterior Apprehension
      • Biceps Load Test II
      • Drop Arm Sign
      • External Rotation Lag Sign
      • Hawkins-Kennedy Impingement Sign
      • Horizontal Adduction Test
      • Internal Rotation Lag Sign
      • Jobe Test
      • Ludington's Test
      • Neer Test
      • Painful Arc Sign
      • Pronated Load Test
      • Resisted Supination External Rotation Test
      • Speed's Test
      • Posterior Apprehension
      • Sulcus Sign
      • Thoracic Outlet Tests >
        • Adson's Test
        • Costoclavicular Brace
        • Hyperabduction Test
        • Roos (EAST)
      • Yergason's Test
    • Elbow >
      • Biceps Squeeze Test
      • Chair Sign
      • Cozen's Test
      • Elbow Extension Test
      • Medial Epicondylalgia Test
      • Mill's Test
      • Moving Valgus Stress Test
      • Push-up Sign
      • Ulnar Nerve Compression Test
      • Valgus Stress Test
      • Varus Stress Test
    • Wrist/Hand >
      • Allen's Test
      • Carpal Compression Test
      • Finkelstein Test
      • Phalen's Test
      • Reverse Phalen's Test
    • Hip >
      • Craig's Test
      • Dial Test
      • FABER Test
      • FAIR Test
      • Fitzgerald's Test
      • Hip Quadrant Test
      • Hop Test
      • Labral Anterior Impingement Test
      • Labral Posterior Impingement Test
      • Long-Axis Femoral Distraction Test
      • Noble Compression Test
      • Percussion Test
      • Sign of the Buttock
      • Trendelenburg Test
    • Knee >
      • Anterior Drawer Test
      • Dial Test (Tibial Rotation Test)
      • Joint Line Tenderness
      • Lachman Test
      • McMurray Test
      • Noble Compression Test
      • Pivot-Shift Test
      • Posterior Drawer Test
      • Posterior Sag Sign
      • Quad Active Test
      • Thessaly Test
      • Valgus Stress Test
      • Varus Stress Test
    • Foot/Ankle >
      • Anterior Drawer
      • Calf Squeeze Test
      • External Rotation Test
      • Fracture Screening Tests
      • Impingement Sign
      • Navicular Drop Test
      • Squeeze Test
      • Talar Tilt
      • Tarsal Tunnel Syndrome Test
      • Test for Interdigital Neuroma
      • Windlass Test
    • HEP >
      • Neck and Shoulder >
        • Supine Chin Tuck
        • Supine DNF with Towel Assist
        • Supine DNF
        • Standing Chin Tuck Against Wall
        • Standing Chin Tuck Against Wall with Scaption
        • Seated Cervical Retraction Repeated
        • Seated Cervical Retraction with Extension Repeated
        • Seated Cervical Retraction with Sidebend Repeated
        • Seated Cervical Retraction with Rotation Repeated
        • Standing Wall Shrugs at 90 Degrees Flex
        • Seated Thoracic Whips
        • Standing Ballistic Shoulder Extensions
        • Standing Repeated Shoulder Extension with Squat
        • Standing Repetead Shoulder Horiz. Abd. with Ext. CKC
        • Seated with Arms on Pillows Cervical AROM (Flex/Ext/Rot/SB)
        • Seated with Arms on Pillows Shrugs
        • Seated with Arms on Pillows Shrug with Scapular Retraction
        • Supine Shoulder IR with GH Centralization
        • Supine Shoulder ER with GH Centralization
        • Holding Dumbbell at 180 Degrees Flexion for Time
        • Cat Camel
        • Prone T's
        • Prone Y's
        • Quad Chin Tuck w/ Shoulder Flexion
      • Low Back >
        • Supine TA Isometric
        • Standing TA Isometric Agains Wall with Squat
        • Supine BKFO
        • Quad Rock Back
        • Standing Hip Hinge
        • Sit to Stand with Hip Hinge
        • Repeated Lumbar Sideglides
        • Repeated Standing Lumbar Extension
        • Repeated Standing Lumbar Flexion
        • Repeated Prone Press-Ups
        • Repeated Supine DKC
        • Slump Sciatic Nerve Glides
        • Birddog Progression
      • Hip and Knee >
        • Clamshells with Progressions
        • Fire Hydrants with Progressions
        • Donkey Kicks
        • Bridge Variations
        • Repeated Hip Flexion
        • Squats
        • Seated Repeated Knee Extensions
        • CKC Seated Repeated Knee Extensions
        • Heel Slides
        • CKC DF with Tibial IR
      • Foot and Ankle >
        • Calf Raises
        • Calf Raises with Soccer Ball Between Medial Malleoli
        • Towel Scrunches with Foot in PF
        • Toe Flexion Using T-Band with Foot in PF
        • PF with Toes Flexed Using T-Band
        • DF with Toes Flexed Using T-Band
        • Forefoot Adduction
        • Gastroc Stretch
        • Repeated PF
      • Examination Templates

The Knee

Range of Motion

Picture
ROM Using a Goniometer (Norkin and White, 2003):
Flexion: 135-150 degrees
Extension: 0 degrees

Manual Muscle Tests

Coming soon....

Special Tests

Anterior Drawer Test
Dial Test (Tibial Rotation Test)
Joint Line Tenderness
Lachman Test
McMurray Test
Noble Compression Test
Pivot-Shift Test
Posterior Drawer Test
Posterior Sag Sign
Quad Active Test
Thessaly Test
Valgus Stress Test
Varus Stress Test
Picture
Picture

Knee Research

Cluster for Meniscal Injury (Lowery et al, 2006):
-History of Joint Locking
(+) Joint Line Tenderness
(+) McMurray Test
-Pain with Flexion Overpressure
-Pain with Extension Overpressure

3 positive: Sn .31, Sp .9, +LR 3.15, -LR .77
4 positive: Sn .17, Sp .96, +LR 4.29, -LR .86
5 positive: Sn .11, Sp .99, +LR 11.45, -LR .9

Cluster for MCL Injury (Kastelein et al, 2008):
-History (1 or 2: external force, rotational trauma)
-Pain with Valgus Stress at 30 degrees
-Laxity with Valgus Stress at 30 degrees

Sn .56, Sp .91, +LR 6.4, -LR .5

Clinical Diagnosis of Knee Osteoarthritis (Cibere et al, 2004):
-Age > 50 years
-Stiffness > 30 min.
-Crepitus
-Bony tenderness
-Bony enlargement
-No palpable warmth

At least 3 positive: Sn .95, Sp .69, +LR 3.1, -LR .07

Cluster for Patients with Knee OA Likely to Respond to Hip Mobilization (Currier LL et al, 2007):

-Hip or groin pain or paresthesia
-Anterior thigh pain
-Passive knee flexion <122 deg
-Passive hip IR < 17 deg
-Pain with hip distraction

1 variable: +LR 5.1
2 variables: +LR 12.9

Ottawa Knee Rules (Steil et al, 1999):
-Age > 55 years
-Isolated patellar tenderness without other bone tenderness
-Tenderness of the fibular head
-Inability to flex to 90 degrees
-Inability to bear weight immediately after injury and in the emergency department (4 steps) regardless of limping

(Adults): Sn 1.0, Sp .49-.56, +LR 1.8, -LR 0
(Pediatrics): Sn 1.0, Sp .43, +LR 1.8, -LR 0

Note: tests should only be used by properly trained health care practitioners

References:
Bachmann LM, Haberzeth S, Steurer J, et al. "The accuracy of the Ottawa knee rule to rule out knee fractures: a systematic review." Ann Intern Med 2004; 140(2):
​121-124.


Bulloch B, Neto G, Plint A, et al. "Validation of the Ottawa Knee Rule in children: a multicenter study." Ann Emerg Med 2003; 42(1): 48-55.

Cibere J, Bellamy N, Thorne A, Esdaile JM, McGorm KJ, Chalmers A et al. "Reliability of the knee examination in osteoarthritis: effect of standardization." Arthritis      
Rheum
2004; 50(2): 458-468.


Currier LL, et al. Development of a Clinical Prediction Rule to Identify Patients with Knee Pain and Clinical Evidence of Knee OA who Demonstrate a Favorable Short-Term Response to Hip Mobilization. Physical Therapy. 2007; 87(9): 1106-1119.

Kastelein M, Wagemakers HP, Luijsterburg PA, Verhaar JA, Koes BW, Bierma-Zeinstra SM. "Assessing medial collateral ligament knee lesions in general practice."       The American journal of medicine. Nov 2008; 121(11):982-988 e982.

Ketelslegers E, Collard X, Vande BB, et al. "Validation of the Ottawa knee rules in an emergency teaching centre." Eur Radiol 2002; 12(5): 1218-1220.

Khine H, Dorfman DH, Avner JR. "Applicability of Ottawa knee rule for knee injury in children." Pediatr Emerg Care 2001; 17(6):401-404.
Lowery DJ, Farley TD, Wing DW, Sterett WI, Steadman JR. "A clinical composite score accurately detects meniscal pathology." Arthroscopy. Nov 2006; 22(11):1174-   1179.

Norkin C, White DJ. "Measurement of Joint Motion: A Guide to Goniometry." 3rd ed. Philadelphia: F.A. Davis Company, 2003. Print.

Stiell IG, Greenberg GH, Wells GA, et al. "Derivation of a decision rule for the use of radiography in acute knee injuries." Ann Emerg Med 1995; 26(4): 405-413.


Stiell IG, Greenberg GH, Wells GA, et al. "Prospective validation of a decision rule for the use of radiography in acute knee injuries." JAMA 1996; 275(8): 611-615.

Stiell IG, Wells GA, Hoag RH, et al. Implementation of the Ottawa Knee Rule for the use of radiography in acute knee injuries." JAMA 1997; 278(23): 2075-2079.


Stiell IG, Wells GA, McDowell I, et al. "Use of radiography in acute knee injuries: need for clinical decision rules." Acad Emerg Med 1995; 2(11):966-973.

Stiell IG, Wells GA, McKnight RD. Validating the "real" Ottawa Knee Rule." Ann Emerg Med 1999; 33(2):241-243.


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Copyright © The Student Physical Therapist LLC 2020
  • Home
    • Newsletter
    • About
  • Insider Access
    • About Insider Access
  • Brian's Corner
    • Sports & Entrepreneurship Blog
    • Return to Sport Tests
    • PT Entrepreneur Course
    • Return to Sport Essentials Course
    • Become a PAID PT Consultant Course
  • Chris' Corner
  • Jim's Corner
    • Orthopedic Blog
  • Special Tests
    • Cervical Spine >
      • Alar Ligament Test
      • Bakody's Sign
      • Cervical Distraction Test
      • Cervical Rotation Lateral Flexion Test
      • Craniocervical Flexion Test (CCFT)
      • Deep Neck Flexor Endurance Test
      • Posterior-Anterior Segmental Mobility
      • Segmental Mobility
      • Sharp-Purser Test
      • Spurling's Maneuver
      • Transverse Ligament Test
      • ULNT - Median
      • ULNT - Radial
      • ULNT - Ulnar
      • Vertebral Artery Test
    • Thoracic Spine >
      • Adam's Forward Bend Test
      • Passive Neck Flexion Test
      • Thoracic Compression Test
      • Thoracic Distraction Test
      • Thoracic Foraminal Closure Test
    • Lumbar Spine/Sacroiliac Joint >
      • Active Sit-Up Test
      • Alternate Gillet Test
      • Crossed Straight Leg Raise Test
      • Extensor Endurance Test
      • FABER Test
      • Fortin's Sign
      • Gaenslen Test
      • Gillet Test
      • Gower's Sign
      • Lumbar Quadrant Test
      • POSH Test
      • Posteroanterior Mobility
      • Prone Knee Bend Test
      • Prone Instability Test
      • Resisted Abduction Test
      • Sacral Clearing Test
      • Seated Forward Flexion Test
      • SIJ Compression/Distraction Test
      • Slump Test
      • Sphinx Test
      • Spine Rotators & Multifidus Test
      • Squish Test
      • Standing Forward Flexion Test
      • Straight Leg Raise Test
      • Supine to Long Sit Test
    • Shoulder >
      • Active Compression Test
      • Anterior Apprehension
      • Biceps Load Test II
      • Drop Arm Sign
      • External Rotation Lag Sign
      • Hawkins-Kennedy Impingement Sign
      • Horizontal Adduction Test
      • Internal Rotation Lag Sign
      • Jobe Test
      • Ludington's Test
      • Neer Test
      • Painful Arc Sign
      • Pronated Load Test
      • Resisted Supination External Rotation Test
      • Speed's Test
      • Posterior Apprehension
      • Sulcus Sign
      • Thoracic Outlet Tests >
        • Adson's Test
        • Costoclavicular Brace
        • Hyperabduction Test
        • Roos (EAST)
      • Yergason's Test
    • Elbow >
      • Biceps Squeeze Test
      • Chair Sign
      • Cozen's Test
      • Elbow Extension Test
      • Medial Epicondylalgia Test
      • Mill's Test
      • Moving Valgus Stress Test
      • Push-up Sign
      • Ulnar Nerve Compression Test
      • Valgus Stress Test
      • Varus Stress Test
    • Wrist/Hand >
      • Allen's Test
      • Carpal Compression Test
      • Finkelstein Test
      • Phalen's Test
      • Reverse Phalen's Test
    • Hip >
      • Craig's Test
      • Dial Test
      • FABER Test
      • FAIR Test
      • Fitzgerald's Test
      • Hip Quadrant Test
      • Hop Test
      • Labral Anterior Impingement Test
      • Labral Posterior Impingement Test
      • Long-Axis Femoral Distraction Test
      • Noble Compression Test
      • Percussion Test
      • Sign of the Buttock
      • Trendelenburg Test
    • Knee >
      • Anterior Drawer Test
      • Dial Test (Tibial Rotation Test)
      • Joint Line Tenderness
      • Lachman Test
      • McMurray Test
      • Noble Compression Test
      • Pivot-Shift Test
      • Posterior Drawer Test
      • Posterior Sag Sign
      • Quad Active Test
      • Thessaly Test
      • Valgus Stress Test
      • Varus Stress Test
    • Foot/Ankle >
      • Anterior Drawer
      • Calf Squeeze Test
      • External Rotation Test
      • Fracture Screening Tests
      • Impingement Sign
      • Navicular Drop Test
      • Squeeze Test
      • Talar Tilt
      • Tarsal Tunnel Syndrome Test
      • Test for Interdigital Neuroma
      • Windlass Test
    • HEP >
      • Neck and Shoulder >
        • Supine Chin Tuck
        • Supine DNF with Towel Assist
        • Supine DNF
        • Standing Chin Tuck Against Wall
        • Standing Chin Tuck Against Wall with Scaption
        • Seated Cervical Retraction Repeated
        • Seated Cervical Retraction with Extension Repeated
        • Seated Cervical Retraction with Sidebend Repeated
        • Seated Cervical Retraction with Rotation Repeated
        • Standing Wall Shrugs at 90 Degrees Flex
        • Seated Thoracic Whips
        • Standing Ballistic Shoulder Extensions
        • Standing Repeated Shoulder Extension with Squat
        • Standing Repetead Shoulder Horiz. Abd. with Ext. CKC
        • Seated with Arms on Pillows Cervical AROM (Flex/Ext/Rot/SB)
        • Seated with Arms on Pillows Shrugs
        • Seated with Arms on Pillows Shrug with Scapular Retraction
        • Supine Shoulder IR with GH Centralization
        • Supine Shoulder ER with GH Centralization
        • Holding Dumbbell at 180 Degrees Flexion for Time
        • Cat Camel
        • Prone T's
        • Prone Y's
        • Quad Chin Tuck w/ Shoulder Flexion
      • Low Back >
        • Supine TA Isometric
        • Standing TA Isometric Agains Wall with Squat
        • Supine BKFO
        • Quad Rock Back
        • Standing Hip Hinge
        • Sit to Stand with Hip Hinge
        • Repeated Lumbar Sideglides
        • Repeated Standing Lumbar Extension
        • Repeated Standing Lumbar Flexion
        • Repeated Prone Press-Ups
        • Repeated Supine DKC
        • Slump Sciatic Nerve Glides
        • Birddog Progression
      • Hip and Knee >
        • Clamshells with Progressions
        • Fire Hydrants with Progressions
        • Donkey Kicks
        • Bridge Variations
        • Repeated Hip Flexion
        • Squats
        • Seated Repeated Knee Extensions
        • CKC Seated Repeated Knee Extensions
        • Heel Slides
        • CKC DF with Tibial IR
      • Foot and Ankle >
        • Calf Raises
        • Calf Raises with Soccer Ball Between Medial Malleoli
        • Towel Scrunches with Foot in PF
        • Toe Flexion Using T-Band with Foot in PF
        • PF with Toes Flexed Using T-Band
        • DF with Toes Flexed Using T-Band
        • Forefoot Adduction
        • Gastroc Stretch
        • Repeated PF
      • Examination Templates