Knee (standard tests)

Case 5

You have a practice at a general practitioner’s office. Your supervisor has scheduled a healthy 17-year-old woman for you for a clinical examination due to knee pain.

She is in high school and says that she plays handball and runs a lot in her free time. She reports that over the past six months she has felt pain during activity on the inside of her lower leg just below the knee joint. She has not injured herself.

Knee examination

• Perform standard knee examination
  • Inspection
  • Active movement
  • Passive movement
  • Isometric movement
  • Palpation

1. You perform an inspection, what are you looking for?
2. You ask the patient to perform active movements, what do you expect to find?
3. You perform passive movements, what do you expect to find?
4. You perform isometric movements.
5. You palpate around the knee joint, identify and palpate the patellar tendon and show the patella dip test.

Knee inspection

Active knee movement

Passive knee movement

Isometric knee movement

Knee palpation

Clinical findings

• On inspection, you can see a slight local swelling in the area the patient indicates pain, the upper medial part of the tibia.
• During active squatting, she reports pain localized on the inside of the upper part of the calf.
• Normal passive movement in the knee joint.
• You find a positive isometric test for internal rotation of the calf.
• On palpation over the affected area, she reports pain.

Cases