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Special Test

Knee Girth Measurement

Knee Girth Measurement is used to determination of the amount of fluid in and around the knee joint and atrophy of the quadriceps muscle groups.

To be objective, these measurements must be made in a consistent and reproducible manner.

See Also: Ankle Girth Measurement

How do you measure the knee girth?

The patient is Supine or standing (The patient should be in the same position each time a measurement is taken.), while the examiner Standing next to the patient.

The joint line is identified and measured at the 0 inch mark. Measurements are taken at 5-, 10-, and 15 cm intervals above the joint line. Measurements are taken at 15 cm below the joint line.

Knee Girth
Knee girth is determined by identifying the joint line (0 mark)
Knee Girth Measurement 2
Measuring above and below the joint line. Measurements are made around the joint line and then at consistent intervals up the quadriceps group

What does a positive Knee Girth Measurement mean?

A difference of ±1 cm compared bilaterally, where:

  • Increased Knee Girth Measurement on the injured side across the joint line indicating an edema.
  • Decreased muscular girth on the injured side indicating a muscular atrophy.

The measurement increments can be increased for taller individuals and decreased for shorter people.

See Also: Knee Muscles Anatomy

Releability

The Inter-rater Reliability is 0.72-0.97, while the Intra-rater Reliability is 0.82-1.00.

Notes

Standardization of the measurements is required for accurate results (e.g., the patient in the same position, same landmarks).

In the case of migrating edema, ankle and calf girth measurements should also be taken.

There is only a slight to moderate relationship between strength and girth in the overall population.

Ongoing reexamination of existing conditions must include a determination of the amount of fluid in and around the knee joint and atrophy of the quadriceps muscle groups. To be objective, these measurements must be made in a consistent and reproducible manner.

Following disuse secondary to trauma, including surgery, the volume of the quadriceps muscles significantly decreases relative to the uninvolved limb, but this reduction is not typically seen in the hamstring or adductor muscles. Within the quadriceps group, all muscles tend to atrophy at the same rate, but the vastus medialis and rectus femoris lose slightly more volume.

Note that the muscles of the dominant thigh may naturally be hypertrophied relative to the nondominant thigh, and measurements are more accurate in lean individuals, especially when performed by the same examiner.

References

  1. Akima H, Furukawa T. Atrophy of thigh muscles after meniscal lesions and arthroscopic partial menisectomy. Knee Surg Sports Traumatol Arthrosc. 2005 Nov;13(8):632-7. doi: 10.1007/s00167-004-0602-9. Epub 2005 Apr 13. PMID: 15827765.
  2. Tothill, P, and Stewart, AD: Estimation of thigh muscle and adipose tissue volume using magnetic resonance imaging and anthropometry. J Sports Sci, 20:563, 2002.
  3. Soderberg, GL, Ballantyne, BT, and Kestel, LL: Reliability of lower extremity girth measurements after anterior cruciate ligament reconstruction. Physiother Res Int, 1:7, 1996.
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