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How to examine the knee

Other platforms explain it with text and video. In Making Synapses you practice it on the patient.

MD / DOPA
Practice it in VR with Blocky

The knee exam checks the joint, its ligaments and its menisci. The Ottawa knee rules help decide who needs an X-ray after an injury.

Step by step

  1. Prepare

    Introduce yourself, get consent and expose both legs. [1]

  2. Look standing and walking

    Alignment (bow legs or knock knees), limp, swelling behind the knee. [2]

  3. Look and feel lying down

    Swelling, redness, thigh muscle wasting, temperature, and tenderness along the joint lines. [2]

  4. Fluid in the joint

    Patellar tap for a large effusion, bulge sign for a small one. [2]

  5. Range of motion

    Full straightening and bending, active then passive. [1]

  6. Ligaments

    Lachman and anterior drawer (ACL), posterior drawer (PCL), and side stress at full extension and 30 degrees (MCL and LCL). [2]

  7. Menisci

    Joint line tenderness and McMurray test (pain or click with rotation). [2]

  8. X-ray decision

    Ottawa knee rules: age 55 or older, tenderness only at the kneecap or at the head of the fibula, cannot bend to 90 degrees, or cannot take four steps. [1]

Common errors

Practice it in Making Synapses

In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.

Making Synapses cases that train this skill

37 Making Synapses cases train this skill: open the case library

Sources

  1. NCCPA PANCE Content Blueprint
  2. Stanford Medicine 25 (bedside exam)

Facts and steps follow NCCPA PANCE Content Blueprint; Stanford Medicine 25 (bedside exam). Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.