Examination of the joint
In a clinical examination for acute pain in the joint, the doctor assesses the shape and position of the limb, the volume of the hip, the condition of the popliteal ligament and the leg muscles, notes the presence of redness, local fever, or swelling; analyzes the gait of the patient (if he can walk), compares the length of the legs. Then the doctor assesses the amount of passive movements in the joint and its stability. In the future, depending on the type of damage, X-ray and surgical methods are used.
Typical Symptoms
The main symptoms of knee injury are pain and swelling. In some cases, the skin shows bruises and redness. With palpation, bone displacement can be detected, as well as instability or impossibility of full extension of the joint. Some clinical signs may indicate a chronic process that preceded trauma. For example, X-shaped and O-shaped deformities of the limbs, excessively protruding knee joints are observed in disorders of growth, arthritis, poliomyelitis or rickets.
• Quite often the knee joint is injured during sports, such as playing soccer. The most common injuries are fractures, bone dislocations, ligament ruptures and meniscal injuries. Most often, patients after a knee injury are admitted to the emergency room with swelling of the joint bag, meniscus damage and ligament rupture. The doctor conducts a sequential examination of the knee in the position of the patient lying on his back. To identify the cause of pain and assess the volume of movements in the damaged joint, special tests are used.
Inspection
The examination of the knee joint begins with an examination. Redness and swelling of the joint indicate the presence of acute inflammation. Also, attention should be paid to deformation and compaction of tissues.
Palpation
At palpation it is possible to detect the presence of edema (fluid accumulation in the periarticular tissues). Swelling of any origin indicates damage to the joint and requires a complete examination.
The Lachmann test
Stability of the knee joint is provided by cruciate ligaments. Lahman's anterior and posterior tests reveal the tears of the anterior and posterior cruciate ligaments, respectively.
McMurray Test
The McMurray test reveals a break in the meniscus. The doctor rotates more than the tibia relative to the hip and slowly unbends the knee. If the meniscus is damaged, pain occurs.
Extension
The volume of active and passive extensor movements in the knee joint is assessed. Restriction of the volume of movements indicates a blockade of the knee joint or weakness of the quadriceps muscle.
Bending
The accumulation of exudate often leads to a decrease in the amount of flexion movements in the knee joint. Damage to the collateral ligaments can be detected by flexing the knee joint by 30 degrees with subsequent extension.
X-ray examination
X-ray examination can reveal fractures, for example, a patellar fracture, dislocations and arthritis. In addition to the standard (anteroposterior and lateral), additional special projections can be used.
Puncture
The synovial fluid is examined for examination of the knee joint. Puncture of the knee joint is carried out with the help of a special needle, which is inserted into the articular cavity through the puncture of the skin. If the degree of damage to the knee joint could not be determined by objective examination, additional methods are used: Arthroscopy - examination of the knee cavity using a special optical instrument. It allows to detect the tearing of menisci and the presence of free cartilaginous bodies in the joint cavity. With the help of an arthroscope, it is possible to remove free bodies and restore the integrity of menisci. MRI (magnetic resonance imaging) can detect damage to the soft tissues of the joint and confirm the alleged diagnosis.