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Visual testing by eliciting fluctuation


The subject lies in the supine position with the leg extended.


The examiner strokes in a sweeping motion with the back of one hand over the lateral recessus and the suprapatellar pouch. This moves the fluid upwards and medially. In minor effusion, all the fluid is moved to the medial part […]

Eliciting fluctuation


The subject lies in the supine position with the leg extended. The examiner stands level with the knee. He places thumb and index finger of one hand at each side of the knee,just beyond the patella. The interdigital web I-II of the other hand is on the suprapatellar pouch.


The examiner squeezes the […]



The subject lies in the supine position with the knee slightly bent. The examiner stands level with the knee. One forearm is placed under the knee with the hand resting on the other knee, proximal to the patella. The other hand is on the distal end of the leg just proximal to the […]

Anterior drawer test


The subject lies in the supine position with the knee flexed to a right angle, and the heel resting on the couch. The examiner sits on the foot of the subject. One hand is on the anterior aspect of the knee: apex patellae in the palm of the hand, thenar and hypothenar making contact […]

Palpation of the extensor mechanism

This is performed on an extended knee.First the muscular structures are ascertained. Ask the patient to extend the slightly bent knee and resist the movement.This movement usually outlines the vastus medialis, vastus lateralis, rectus femoris and the patellar ligament. Then the patellar border with its tendinous insertions are palpated. With the hip in flexion and […]

Articular cartilage injuries

The collagen tissue of the articular cartilage has less tensile strength in adolescents than in adults; thus children and young people can injure the articular cartilage more easily than adults as a result of sprains and direct blows. A prolonged extreme load on the knee joint, e.g. in downhill skiing or sailing, can result in […]

Traction tendinitis

Sinding-Larsen-Johansson disease

Sinding-Larsen-Johansson disease is a traction tendinitis of the distal pole of the patella, caused by microtrauma. It is seen in growing individuals; who have pain at the inferior pole of the patella in association with running and jumping. Typical clinical signs are point tenderness at the inferior pole of the patella, swelling, limitation […]

Knee extension mechanism injuries

The knee extension mechanism includes the quadriceps muscle-tendon, the patellar bone, the patellar tendon, and its insertion into the tibia. Injuries can occur in all these structures.

Quadriceps tendon injuries The distal quadriceps tendon attaches to the patella and its adjacent soft tissue structures (the retinaculum). It is important for the extensor mechanism. This tendon […]


The knee is the most frequently injured joint in athletics.Most injuries are due to the extreme stresses of twisting and turning activities such as those found in skiing, soccer, and American football. Medial collateral ligament and meniscal injuries are in the majority, but anterior cruciate ligament ruptures are also common and are responsible for a […]

Prepatellar Bursitis


There is gradual or acute onset of localised swelling and inflammatory signs over the patella.


The bursitis can develop from a direct trauma and bleeding or from repetitive stress, when synovial fluid fills the bursa (housemaid’s knee) or when pus from infected superficial skin wounds penetrates the bursa.


There […]