Method Of Exam

Inspect the muscles of the hip, knee and ankle.

• Note muscle size (bulk).
• Look for asymmetry, atrophy and fasciculation.
• Look for abnormal movement.
• Determine muscle power by gently trying to overpower contraction of each group of muscles.
  • Hip: Flexion (Iliopsoas), Extension (Gluteus maximus), Abduction, Adduction.
  • Knee : Flexion (Hamstrings), Extension (Quadriceps)
  • Ankle : Dorsiflexion (Tibialis anterior), Plantar flexion (Gastronemius).
• Determine limb tone (resistance to passive stretch). With the patient relaxed, gently move the limb at the hip, knee and ankle and note whether tone is normal, increased or dicreased.
  Flex the hip and knee. Support the knee, dorsiflex the ankle sharply and hold the foot in this position checking for clonus.