Determine the mechanism of knee injury and review all prior orthopedic injuries
or surgical procedures. Assess gait (if possible), functional range of
motion, and the ability of the patient to extend the flexed knee
against minimal resistance. Inspect the knee for swelling, ecchymoses,
effusion, masses, patella location and size, muscle mass, erythema,
and evidence of local trauma. With the patient supine, determine
whether leg lengths are equal or unequal. Last, ask the patient
to demonstrate the best possible active range of motion. Assess
pulses and distal neurologic function. As with all orthopedic examinations, the noninjured or normal knee should
be compared with the injured knee during all aspects of the examination,
but especially during palpation and stress testing. When
palpating the knee, begin in the nontender areas and work toward
the tender area to minimize patient apprehension. Palpate the patella,
patellar facets, and femoral and tibial condyles for pain and crepitus.
Make note of joint effusion, tenderness, increased temperature,
strength, sensation, and location of pulses.