THE INTEGRATED KNEEA combined approach using gross anatomy, physical diagnosis and

point of care ultrasound.

Goals Understand the anatomy of the knee

using ultrasound as a learning tool. Understand utility of ultrasound to

supplement the physical exam. Understand the sonographic appearance

of different tissue types and the identification of pathology of the knee.

Learning Objectives1. Describe the normal anatomy of the knee.2. Explain the rationale behind ultrasound transducer utilization in a

musculoskeletal exam.3. Describe the different appearances of tissue types on ultrasound

imaging.4. Demonstrate these standard ultrasound views of the knee:

suprapatella long, infrapatella long (proximal and distal) and suprapatella flexed transverse.

5. Correlate the normal anatomy of the knee to its appearance on ultrasound imaging.

6. Recognize the most common pathologies visualized on ultrasound, including joint effusion, tendonitis, and tendon tear.

7. Recognize the ultrasound correlate of a joint effusion fluid wave on physical exam.

8. Demonstrate appropriate communication skills and show empathy towards patient.

Delivery of Session• Organization:• 2 hr Anatomy Lab • 30 min PE• 30 min Ultrasound

• Materials:• Cadaver• US Equipment• PE Tables• Students will

scan/examine each other

• Preparation:• Videos – PD techniques• SUSME• Textbooks - anatomy• Review

PowerPoint/Lecture• Faculty:

• US Faculty (MD/Tech)• PD Faculty (MD)• Anatomy Faculty

(MD/PhD)

Integrated Assessment Standardized Patient

Students are required to submit 3 views with labeling: quad. tendon, infrapatella tendon, bone (patella, femur, tibia)

Communication skills Scan reasons and techniques clearly. Exam performed with courtesy and consideration

for patient comfort

Integrated Assessment Standardized Patient

Physical Exam: Flex / Extension Varus, Valgus

Compare and contrast the medial and lateral ligaments to the joint capsule.

Anterior / Posterior Draw Describe the positioning of the knee typical for injury to the ACL

and explain why. Ballottement

Ballottement tests for fluid in the suprapatella bursa, what other bursas exist around the knee joint and how would you examine them.

Integrated Assessment Image Pathology:

Joint Effusion, Ruptured Ligamentum Patella Anatomical:

Surface anatomy – landmarks indicated on surface of standardized patient.

Anatomical question to each PE maneuvers. (muscle, nerve)

Additional anatomical structures as necessary.