Movement

Before examining the knee, a quick movement test for hip pathology should be performed e.g. testing for pain on flexing and internally rotating the hip. Examination of the knee may then be performed with the patient supine:

• Active / passive movements:

- flexion - measure in degrees from a neutral position of full extension - normal flexion is at least 135 degrees; alternatively, measure the heel to buttock distance

- extension - full extension should be possible with both knees; if there is a block to extension, it may be springy or rigid; hyperextension may be possible - lift up both feet off the bed to demonstrate

- feel for joint crepitus along the articulating surfaces whenever possible

• extensor lag - assessed with the straight leg raise
  
  
• patellar apprehension test
  
  
• patellar grind test
  
  
• test for cruciate integrity - anterior and posterior drawer, Lachmann's test
  
  
• pivot shift test
  
  
• collaterals stressed in extension and slight flexion
  
  
• test for torn meniscus - McMurray's test, Apley's grinding test