Physical exam to diagnose a serious knee injury

When examining a patient after a serious injury, a doctor or an orthopaedic surgeon often obtains an MRI to assess the extent of injury. There are instances where the history of the injury and the physical exam can suggest what structures are injured. In this Ask Dr. Geier video, I explain how and when doctors can make the diagnosis of ACL, MCL and meniscus tears.

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Christina asks:
Hi Dr. Geier,
I was told that a lot of ACL injuries are not isolated injuries. Almost half of the time, people could also have torn their MCL or meniscus at the same time of tearing the ACL. Without an MRI, would an orthopedic surgeon be able to get a full picture of all the damage in the knee? Are there tests to determine MCL and meniscus damage as well? I’m currently on a super long waiting list to get an MRI… It would be nice to hear your opinion. Thanks!

There are a number of physical exam tests that can demonstrate specific injuries of the knee. For example, in the McMurray’s test, the surgeon fully flexes the patient’s knee and internally rotates the knee. If the patient has pain along the joint line with the McMurray’s test, it suggests that the patient could have a meniscus tear.

The medial collateral ligament (MCL) protects the knee against valgus stress (stress that opens up the medial side or inside of the knee). The surgeon can place the knee in different degrees of flexion and assess how much the knee opens with valgus stress.

Finally, a Lachman’s test and pivot shift test can demonstrate that a patient has a torn ACL. Unfortunately, shortly after the injury occurs, the knee can be swollen and stiff, making the exam difficult.

In this Ask Dr. Geier video, I discuss the use of physical exam and MRI to determine what structures a patient has injured after a knee injury.

Please remember, while I appreciate your questions, I cannot and will not offer specific medical advice by email, online, on my show, or in the comments at the end of these posts. My responses are meant to provide general medical information and education. Please consult your physician or health care provider for your specific medical concerns.

Видео Physical exam to diagnose a serious knee injury канала Dr. David Geier