This is a test I do on all my knee patients. A positive test indicates that the knee is likely to have some intra-articular pathology - in layman's terms, something inside the knee isn't happy. This could be ACL injury, meniscus injury, cartilage injury and joint synovitis (just to name a few).

The test can be graded by the amount of fluid observed whilst swiping the knee up and down. Notice the bulge of fluid that returns to the inside of the knee after I push on the outside of the knee.

Based on the grading below, this patient has a grade 1 knee effusion.

Grading:
0 - no fluid-wave while performing a downward stroke.
Trace - a small bulge on the medial aspect of the knee
1+ - a larger bulge
2+ - medial fluid returns to its position without performing a downward sweep
3+ - excess of fluid that makes it impossible to stroke the medial fluid away

Do you have a knee effusion? If so, what's your grade?

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