Abstract
Musculoskeletal symptoms are consistently one of the most commonly cited reasons for visits to ambulatory care centers every year, with knee pain accounting for approximately one-third of the reported complaints. Previous studies have demonstrated that many non-orthopedic physicians report a lack of confidence in performing clinical musculoskeletal knee examinations. “The Rules of Four” approach presented in this paper is designed to present a systematic and concise method to musculoskeletal examination of the knee within a memorable format. The approach allows for the timely diagnosis of common musculoskeletal injuries while aiding in directing further treatment and diagnostic testing. This method will ideally allow medical students and non-orthopedic physicians alike to confidently and effectively evaluate patients with complaints of knee pain in ambulatory care settings.
Highlights
Musculoskeletal symptoms are consistently one of the most commonly cited reasons for visits to primary care providers in their offices or in ambulatory care centers every year. Of these primary care visits, knee pain accounts for approximately one-third of chief complaints.[1,2]
Previous studies have demonstrated that many non-orthopedic physicians report a lack of confidence in performing clinical musculoskeletal examination.[3]
The “Rules of Four” approach described in this paper is a memorable and effective systematic method for a knee examination developed by third author Dr Nallamothu to help non-orthopedic physicians confidently arrive at diagnosis when evaluating a patient’s knee complaint
Summary
Musculoskeletal symptoms are consistently one of the most commonly cited reasons for visits to primary care providers in their offices or in ambulatory care centers every year. The “Rules of Four” approach described in this paper is a memorable and effective systematic method for a knee examination developed by third author Dr Nallamothu to help non-orthopedic physicians confidently arrive at diagnosis when evaluating a patient’s knee complaint. We will divide the knee exam into three columns: medial, middle, and lateral, with each column having four corresponding examination points.
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