Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Palpation of soft tissues at the lateral side

The lateral side of the knee forms a crossing point of different tendons and ligaments.The head of the fibula is identified first. A resisted flexion and/or lateral rotation brings the tendon of the biceps femoris into prominence. The tendon inserts at the top and the posterior aspect of the fibular head in two straps, one in front and one behind the insertion of the lateral collateral ligament. The flexion movement usually also reveals the iliotibial tract which is recognized as a horizontal flat band between biceps and vastus latera lis. The lateral collateral ligament is palpated in the following way. Place the palpating finger on the top of the fibular head. Move the leg outwards, meanwhile keeping the foot on the couch (abduction and lateral rotation in the hip). This movement brings the ligament
under tension. It is palpated as a tough round structure that runs from the head of the fibula to the lateral femoral epicondyle. In this pos.ition the ligament makes an 80° angle with the biceps femoris tendon.

The intra-articular origin of the popliteus tendon at the lateral condyle is identified as follows.The knee is still in a flexed position.Identify the lateral border of the patella. The sharp edge of the lateral epicondyle is easily found about one finger-width below the lateral border. Anteriorly a second bony projection is
identified as the lateral condyle . The groove in between these bony structures forms the area from which the tendon emerges. The latter runs intra-articularly and deep to the lateral collateral ligament to continue in the muscle belly that lies
deeply in the popliteal fossa under the lateral gastrocnemius and the plantaris muscles.

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