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Left Knee Examination
INSPECTION:
Effusion Knee
Deformity Knee
Deformity Freetext
Ecchymosis
Ecchymosis Location
• • •
Ecchymosis Freetext
Inspection Freetext
Previous surgical wound
Surgical wound signs
• • •
PALPATION:
Crepitus Right
Warmth
Tenderness
Comments on tenderness:
Tenderness Location
Comments on tenderness location:
RANGE OF MOTION:
ROM FOR COMMERCIAL INSURANCE
RANGE OF MOTION (NON NO FAULT/WC PATIENTS)
• • •
ROM Comments
IF NO FAULT OR WC CASE PLEASE ROM USE BELOW
ROM Active Normal N=0-130
ROM Active Right N=0-130
MUSCLE/STRENGTH EXAM:
Hamstring Strength
Quadriceps Strength
PROVOCATIVE EXAMS:
FOR LATERAL JOINT SPACE NARROWING
Valgus Instability
Valgus Stress Test
FOR MEDIAL JOINT SPACE NARROWING
Varus Instability
Varus Stress Test
OTHER PROVOCATIVE EXAMS
Ober's Test
[+] Ober's Test (for ITB)
• • •
Lachman's Test Postive
Posterior Drawer Test
Pivot Shift
McMurray Test
Patellar Instability
• • •
Patellar Tilt
Patellar Apprehension
Patellar Tracking
• • •
Calf Swelling
Calf Pain
SENSATION:
Sensation
• • •
Sensation Comments:
GAIT:
Gait Normal
Gait Comments:
Gait Left
• • •
Assistive device
• • •
knee diagram

Left Knee OA (New) Medical Form

Pain Management Specialist

There are 1 copies in use.
Published: Sept. 9, 2024, 2:01 p.m.
Doctor: Dr. History Physical
Rating: 0   /

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