Historical items

Where exactly is the knee pain? (“Point to it with one finger.”)

What is the duration of the pain?

Before the pain started, had there been a change in activities?

Was there an injury to the lower extremity and, if so, what was the direction of the force?

Was there a “pop” at the time of injury?

Was the knee swollen at the time of injury or anytime since?

Is the knee giving way or buckling?

Is the knee locking or catching in extension or flexion?

Is there pain in the hip, thigh, or back?

Physical examination tests

Alignment: are the femur, tibia, and patella in normal alignment during standing and walking?

Range of motion: can the patient actively and/or passively flex and extend the knee?

Effusion: is there a fluid wave or does ballottement of the patella produce a tapping sensation?

Joint line tenderness: is the patient tender along the medial and/or lateral joint lines?

Lachman test: is there a discrete end point when the tibia is anteriorly subluxed on the femur?

Anterior drawer test: is there anterior subluxation of the tibia on the femur?

Posterior drawer test: is there posterior sag or translation of the tibia on the femur?

Lateral pivot shift test: does the tibia “jump” anteriorly when extended or flexed with a valgus stress?

McMurray test: is there a “popping” at the joint line when the knee is extended and rotated?