KneeSchool/Reference/The Clinical Examination Academy
The Clinical Examination Academy
Section 4 · What the hands can tell you, and what they cannot
Twenty-four chapters on examining the knee, written for medical students, MRCS and FRCS candidates, and fellows. All 227 pages are published and awaiting review.
How to read a claim about a test
Examination is not a cheaper scan. It answers a different question, and the commonest error in knee practice is treating an image as the answer to a question only the examination asked.
- Four tiers, not seven. Medical student, MRCS, FRCS and fellowship. There is no junior, patient or consultant tier in this section, which the architecture sets in a single sentence. See decision 024.
- No test carries an accuracy figure. You will not find a sensitivity or a specificity anywhere in this section. The comparative standing of the tests is standard teaching and a specific percentage written from memory is the same class of claim as an invented citation, so the pages state the comparison and the gate refuses the number. See decision 023.
- Where It Misleads is a section, not an aside. Every test fails in patterned ways: an effusion limits a Lachman, guarding abolishes it, an anaesthetised knee exaggerates it. A template with nowhere to say so teaches the manoeuvre and omits the thing that makes a clinician wrong.
- The page map for this section is provisional. Part 1 of the architecture carries the full page map for Sections 0 to 3. Section 4's arrives in Part 2, which this build does not have, so its tiers and boundaries come from one sentence in Part 1 and its scope lines are page titles restated. See decision 024.
The 24 chapters
Every chapter is written. No page in this section has been through evidence verification or consultant review, and each one says so at the top.
4.1
Introduction to Knee Examination
4.2
History Taking
- Pain
- Instability
- Swelling
- Stiffness
- Locking
- Giving Way
- Mechanical Symptoms
- Location of Pain
- Onset
- Severity
- Aggravating Factors
- Relieving Factors
- Night Pain
- Inflammatory Pain
- Referred Pain
- Non-contact Injury
- Contact Injury
- Twisting Injury
- Hyperextension Injury
- Direct Blow
- Dashboard Injury
- Patellar Dislocation Event
- Football
- Cricket
- Rugby
- Skiing
- Running
- Tennis
- Basketball
- Previous Surgery
- Previous Injections
- Previous Physiotherapy
- Previous Imaging
- Previous Rehabilitation
4.3
General Inspection
4.4
Gait Examination
4.5
Alignment Assessment
4.6
Palpation
4.7
Range of Motion
4.8
Effusion Assessment
4.9
Meniscal Examination
4.10
ACL Examination
4.11
PCL Examination
4.12
Medial Knee Examination
4.13
Lateral Knee Examination
4.14
Rotational Instability Examination
4.15
Patellofemoral Examination
4.16
Tendon Examination
4.17
Cartilage Examination
4.18
Osteoarthritis Examination
4.19
Paediatric Knee Examination
4.20
Examination of the Post-operative Knee
4.21
Functional Testing
4.22
Examination Scoring Systems
4.23
Special Situations
Note. Nothing in this section is clinical advice or a substitute for assessment by a clinician. It describes how a knee is examined, it is written from standard teaching rather than from retrieved sources, and no page on it has been reviewed.