🛏️ Side-Lying McMurray's Modification
- Patient lies on unaffected side; affected knee uppermost.
- Hip flexed ~45°, knee flexed comfortably.
- Stabilise pelvis/femur with proximal hand.
- Control tibia/foot with distal hand.
- Medial meniscus: external tibial rotation + valgus while extending.
- Lateral meniscus: internal tibial rotation + varus while extending.
- Positive: click, clunk, locking sensation, or joint-line pain.
Knee Tests
| Test | Assesses | Position | Positive Finding | Modification |
|---|---|---|---|---|
| McMurray | Meniscus | Supine | Click/joint-line pain | Side-lying if supine unavailable. |
| Apley's Compression | Meniscus | Prone | Pain with compression | Side-lying compression through tibia. |
| Apley's Distraction | Ligaments | Prone | Pain with distraction | Side-lying traction modification. |
| Anterior Drawer | ACL | Supine | Anterior translation | Semi-recumbent or side-lying if needed. |
| Posterior Drawer | PCL | Supine | Posterior translation | Semi-recumbent. |
| Lachman | ACL | Supine | Soft end-feel | Preferred in acute/geriatric due less flexion. |
| Valgus Stress | MCL | Supine | Medial pain/laxity | Seated with knee flexed. |
| Varus Stress | LCL | Supine | Lateral pain/laxity | Seated with knee flexed. |
| Patellar Tap | Effusion | Supine | Ballottement | Seated/supported if needed. |
| Bulge Test | Small effusion | Supine | Fluid wave | Seated knee extended if supine unavailable. |
| Patellar Grind / Clarke | Patellofemoral joint | Supine | Retropatellar pain | Gentle only; avoid forcing painful patella. |
🧒 Paediatric Knee Differentials
- Osgood-Schlatter's — tibial tubercle apophysitis
- Discoid meniscus — snapping/clicking lateral meniscus
- Tibial spine avulsion — ACL equivalent in children
- Juvenile idiopathic arthritis — warm, swollen, stiff joint