Physical examination for patellar tracking disorder

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Physical examination for patellar tracking disorder

A physical exam for knee problems includes assessment for patellar tracking disorder. Your health professional will observe you in the following situations.

• As you stand and walk, your health professional will watch for:
  • Signs that a kneecap is abnormally positioned or moving out of place, toward the outer side.
  • Any abnormal body mechanics, such as an unusual gait, that may be contributing to a knee problem.
• While you're sitting with your knees bent over the edge of the exam table, your health professional will:
  • Determine whether your kneecaps are positioned properly. Normally, the kneecap faces forward, centered over the middle of the thighbone when viewed from the front. A malaligned kneecap most frequently faces upwards and is tilted off-center toward the outside of the leg.
  • Watch as you straighten your legs, to check for sideways kneecap movement. Normally, the kneecap moves slightly toward the outside just as the leg straightens; a malaligned kneecap is likely to shift noticeably.
  • Watch as you bend your straightened legs halfway (45-degree angle) down to the floor, to check your lower thigh muscle (quadriceps) strength. Normally, the quadriceps help anchor the kneecap; weak quadriceps often contribute to patellar tracking disorder.

Next, your health professional will:

• Feel the kneecap, as you bend your knee to check for possible cartilage problems underneath the kneecap.
• Press on the areas around your kneecap, to assess for tendon, muscle, or other soft tissue problems.
• Move your leg(s) in various directions, to check for pain and stability of the knee and to assess the range of motion. These maneuvers are also used to check the degree of tightness in the:
  • Knee ligaments.
  • Hamstrings.
  • Iliotibial (IT) band.
  • Thigh muscles (quadriceps).
  • Hips.
  • Achilles tendon at the base of the heel.
• Examine your hips, feet, and ankles to look for problems that may contribute to knee symptoms and to check neurologic and vascular function. This part of the physical exam may possibly include X-ray imaging.

Credits

Last updated:	February 14, 2008
Author:	Shannon Erstad, MBA/MPH
Reviewed By:	Adam Husney, MD - Family Medicine, Kenneth J. Koval, MD - Orthopedic Surgery, Orthopedic Trauma
Editors:	Kathleen M. Ariss, MS, Pat Truman, MATC