Chapter 8
Knee Evaluation and Differential Diagnosis

  1. Introduction
    Principles of Exam:

  2. Subjective exam

    Correlations: mechanism and diagnosis (acute injuries):

    Rotation on a fixed foot:
    Valgus stress:
    Varus stress:
    Correlations: swelling and diagnosis:
    Correlations: pain and diagnosis (acute iniuries):
    Correlations: pain and diagnosis (chronic iniuries)

  3. Observation - in general
    1. Anterior - standing
      • hip, knee levels
      • varus, valgus
      • anteversion, retroversion
      • patellar position
      • tibial torsion
      • pronation, foot alignment
      • muscular development, atrophy

    2. Lateral - standing
      • genu recurvatum

    3. Posterior - standing
      • muscular development, atrophy
      • fibular head levels
      • popliteal crease levels
      • calcaneal position
      • pronation, rearfoot, forefoot positions

    4. Sitting
      • patellar position, motion
      • knee mobility (resting position)
      • femur, tibial lengths

  4. STTT

  5. Special tests:

    Ligamentous laxity (single plane):
    Ligamentous laxity (combination):
    Meniscus injury:
    Plica tests:
    Swelling tests:

  6. Accessory motion

  7. Palpation

  8. Radiography/medical tests

    Correlation of radiographs with diagnosis:
    Radiographs & DJD (Fairbanks changes):
    Ahlback's DJD staging:
    1. joint space narrowing
    2. obliteration of joint space
    3. minor bone attrition
    4. major bone attrition
    5. major bone attrition, often with subluxation and secondary arthrosis of opposite compartment

    Magnetic Resonance Imaging (MRI):

  9. Other considerations

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