Physical exam of the knee

1. What is the McMurray test best used for?
2. What is Apley's Grind Test?
3. What is Apley's Distraction Test?
4. What is the Patella Femoral Grind Test?

Answers:
1. Diagnosis of posterior meniscal tears.
2. Test for diagnosis of torn meniscus. Patient lies prone with knee flexed 90 deg while examiner places downward force on heel while rotating tibia. A positive test elicits pain.
3. Test for ligamentous damage. Same as Grind Test, but a traction is applied rather than a downward force, reducing stress on meniscus. Positive test elicits pain.
4. Test to evaluate quality of patella articulating surfaces. Patient is supine with legs in neutral, while examiner pushes on patella distally while patient contracts quads. Patella should glide smoothly up. Positive test is pain and crepitation.