Osce: How to examine the knee
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Here the author demonstrates how to examine the knee joint during an OSCE exam. Good luck!
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Osce: How to examine the knee
- 1. OSCE: How to examine the knee Dr A Barai MBBS, MRCS, MSc (Critical care) Registrar, Emergency Medicine
- 2. Introduce yourself “Hello, I am Dr Barai. I am the Registrar in the Emergency Department. I would like to examine your knees if that is alright with you”
- 3. Ask about pain “Do you have any pain anywhere? Do you like to have some painkillers before I examine you?”
- 4. Take permission “During the examination I would like you to expose your legs upto the groin if that is alright with you. During the examination I may have to touch your knees and do some manoeuvres if that is alright with you? May I proceed please?”
- 5. Hand washing Tell the patient and the examiner that before you examine the patient you would like to wash your hands
- 6. Look • Ask the patient to stand up on the floor. • Look from front, side and behind • Comment on: - Skin condition: bruises, laceration - Scar mark - Muscle wasting - Deformity - Discharging sinus - Asymmetry
- 7. Gait • Ask the patient to walk a few steps if they are happy to do that. • Look for antalgic gait
- 8. Feel • Ask the patient to lie on the couch • Feel for temperature • Feel quads • Bulge test • Patellar tap test • Bony tenderness over patella, medial and lateral joint lines
- 9. Move • Active flexion and extension • Passive flexion and extension • Comment on the range of movement
- 10. Special tests • Lachman test • Varus and valgus test • McMurray’s test
- 11. Conclude • Thank the patient. • Offer help in dressing him up.
- 12. To the examiner I would like to examine the full neurovascular status of the lower limb and joint above eg the hip joint and joint below eg ankle. I would like to give him analgesia, crutches and would also like to have a xray of the knee to see if there is any bony injury
- 13. Finish Thank both the examiner and the patient before leaving.
- 14. Answer sheet
- 15. Tips to pass this OSCE station • Practise • Practise • Practise
- 16. Any comments or suggestions? Please let me know: drbarai@gmail.com