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Palpation of soft tissues at the medial side

Medial collateral ligament

The medial collateral Hgament is a broad, flat and almost triangular band, with a large insertion on the posterosuperior aspect of the medial femoral epicondyle, dose to the insertion of the adductor magnus tendon. Its fibres
run obliquely, anteriorly and inferiorly, to insert at the medial aspect of the tibia, just behind and slightly under the insertions of the pes anserinus.

The anterior fibres of the ligament are separated from those of the capsule. Therefore the anterior border of the ligament can easily be palpated on an extended knee. Place the thumb just medially to the patellar tendon and in the intercondylar groove. Palpate the bony borders of the joint line in a posterior
direction until the sharp edge of a ligamentous structure is felt to bridge the groove. This is the anterior border of the medial collateral ligament. Continue the palpation along the joint line and notice that the bony borders are now covered completely by the dense ligamentous structure.

The posterior border of the ligament, however,can not be palpated because the posterior fibres blend intimately with those of the posterior capsule and with the medial and posterior border of the medial meniscus.Notice that the anterior border of the ligament is situated more posteriorly than is usually thought. Pes anserinus The pes anserinus (the common insertion of the
semitendinosus, the graciliS and the sartorius) is situated under and behind the medial tibial condyle.Ask the patient to flex and internally rotate
the knee and resist the movement. The three tendinous structures are easily identified from distal to proximal: semitendinosus graciHs; and sartorius.

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