TIS

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:
    Hyperextension:
    Hyperflexion:
    Cutting/deceleration:
    Other:
    Correlations: swelling and diagnosis:
    Correlations: pain and diagnosis (acute iniuries):
    Correlations: pain and diagnosis (chronic iniuries)
    Other:

  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:
    Other:

  6. Accessory motion

  7. Palpation

  8. Radiography/medical tests

    Radiographs:
    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

    Arthrogram:
    Magnetic Resonance Imaging (MRI):

  9. Other considerations

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