Inspection

Observe the gait for a smooth, rhythmic flow as the patient enters the room. The knee should be extended at heel strike and flexed at all other phases of swing and stance.

Stumbling or pushing the knee into extension with the hand during heel strike suggests quadriceps weakness.

Check the alignment and contours of the knees. Observe any atrophy of the quadriceps muscles.

Look for loss of the normal hollows around the patella, a sign of swelling in the knee joint and suprapatellar pouch; note any other swelling in or around the knee.

Bowlegs (genu varum) and knock-knees (genu valgum) are common; flexion contracture (inability to extend fully) in limb paralysis

Swelling over the patella suggests prepatellar bursitis. Swelling over the tibial tubercle suggests infrapatellar or, if more medial, pes anserine bursitis.

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