From the Research
During a physical exam of the knee, several specific areas should be palpated to thoroughly assess for injury or pathology, including the patella, patellar tendon, joint line, medial and lateral collateral ligaments, quadriceps tendon, tibial tubercle, femoral condyles, popliteal fossa, and hamstring and gastrocnemius tendon insertions.
Key Areas to Palpate
- Patella and patellar tendon: check for tenderness, crepitus, or abnormal movement 1
- Joint line: examine medially and laterally for tenderness, which may indicate meniscal tears 2
- Medial and lateral collateral ligaments: palpate along their full length to detect laxity or pain 1
- Quadriceps tendon and tibial tubercle: assess for tenderness or swelling 1
- Femoral condyles: palpate for pain or irregularities 3
- Popliteal fossa: examine posteriorly for masses or tenderness that might indicate a Baker's cyst 1
- Hamstring and gastrocnemius tendon insertions: palpate for tenderness or abnormalities 4
Importance of Standardization
Standardization of the physical examination is crucial to improve reliability, as shown in a study where standardization resulted in substantial improvements in reliability for evaluating physical signs in osteoarthritis patients 3.
Diagnostic Utilities
The diagnostic utilities of palpable dorsalis pedis or posterior tibial pulses and the presence of an ankle-brachial index (ABI) of 0.9 or greater have been evaluated, and a normal physical examination (palpable pulses and ABI ≥ 0.9) was found to be 100% sensitive for ruling out vascular injury 5.