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The patellar tap is a technique used in an examination of the knee to test for knee effusion or "water-on-the-knee". [1] With the examinee lying on their back, the examiner extends the knee and presses the area above the kneecap with the palm of one hand. This pushes fluid under the kneecap and lifts it.
The absence of normal grooves around patella may indicates a patellar intra-articular effusion. There are two ways to confirm the effusion. The knee is extended fully before the examination begins. This first way is the patellar tap.
Knee effusion, informally known as water on the knee, occurs when excess synovial fluid accumulates in or around the knee joint. It has many common causes, including arthritis , injury to the ligaments or meniscus , or fluid collecting in the bursa , a condition known as prepatellar bursitis .
Septic arthritis is the purulent invasion of a joint by an infectious agent [5] [6] with a resultant large effusion due to inflammation. [7] Septic arthritis is a serious condition. It can lead to irreversible joint damage in the event of delayed diagnosis or mismanagement.
Repeated, periodic joint effusions of the knee. Usually one knee is affected but sometimes both knees. Other joints may also be involved along with the knee. Effusions are large, restricting range of motion but significant pain is not a feature. There is usually stiffness. Tenderness of the joint may or may not be present. [1]
On inspection the clinician looks for signs of: trauma; previous surgery ()muscle wasting/muscle asymmetry; edema (swelling) erythema (redness); ulcers – arterial ulcers tend to be on the borders / sides of the foot, neuropathic ulcers on the plantar surface of the foot, venous ulcers tend on be on the medial aspect of the leg superior to the medial malleolus.
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Prepatellar bursitis is an inflammation of the prepatellar bursa at the front of the knee. It is marked by swelling at the knee, which can be tender to the touch and which generally does not restrict the knee's range of motion. It can be extremely painful and disabling as long as the underlying condition persists.