Year: 2026 | Month: March | Volume: 13 | Issue: 3 | Pages: 46-56
DOI: https://doi.org/10.52403/ijrr.20260306
Physical Examination of the Knee: A Review Article
Kadek Arditya Putra Mardana1, Cokorda Gde Oka Dharmayuda2
1Resident of Department of Orthopaedic and Traumatology, Faculty of Medicine, Udayana University/Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia
2Department of Orthopaedic and Traumatology, Faculty of Medicine, Udayana University/Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia
Corresponding Author: Kadek Arditya Putra Mardana
ABSTRACT
The knee is a large, modified hinge joint whose complex anatomy and multiplanar biomechanics make it vulnerable to acute trauma and degenerative disease. A careful physical examination remains the cornerstone of initial knee assessment, helping clinicians localize pathology, estimate severity, and determine the need for imaging or referral. This review summarizes clinically relevant knee anatomy and biomechanics and presents a structured approach to knee examination. The assessment begins with targeted history taking to identify the mechanism of injury, onset of swelling, symptoms of giving way or locking, and pain location. Inspection and palpation then evaluate alignment, swelling/effusion, temperature, tenderness, atrophy, scars, and periarticular masses. Active and passive range of motion are measured to detect extensor lag, fixed flexion deformity, and mechanical blocks, while rotational movements and the screw-home mechanism provide additional kinematic clues. Specific provocative tests are reviewed for common intra-articular and periarticular disorders, including Wilson’s test for osteochondritis dissecans, valgus and varus stress tests for collateral ligament injury, anterior drawer and Lachman tests for ACL deficiency, posterior instability maneuvers for PCL pathology, pivot-shift–based tests for anterolateral rotatory instability, and McMurray, Apley, and Thessaly tests for meniscal tears. Effusion assessment using patellar tap and fluid displacement tests is also discussed. Because individual tests have variable sensitivity and specificity, combining multiple findings and comparing with the contralateral knee improves diagnostic confidence. A systematic, reproducible examination supports accurate bedside diagnosis, guides appropriate investigations, and optimizes subsequent management. Applicable across emergency, sports medicine, and outpatient orthopaedic settings.
Keywords: knee; physical examination; ligament injury; meniscus; diagnostic accuracy
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