Brush / Stroke / Buldge Test for Knee Swelling

Brush Test, also known under the names Stroke Test, Bulge Test or Swipe Test is an orthopedic test to assess minor knee swelling.
According to a study by Sturgill et al. (2009), this test has a substantial degree of reliability with a Kappa value of k= 0.75.
For this reason, we give this test a moderate clinical value in practice.
Agreement was scored when two raters scored the same grade or one grade apart (see below for details).

Execution:

1. Patient is in supine lying position with the knee extended
2. The examiner then brushes 2-3 times over the patient’s medial knee in distal to proximal direction (toward the patient’s hip)
3.  The examiner then brushes 2-3 times down the lateral side of the knee with the opposite hand in proximal to distal direction.

Positive Outcome: A wave of fluid floating down the medial and distal side of the knee where it bulges mediodistally indicates a joint effusion

21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE

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Another test to assess for swelling in the knee joint is the Patellar Tap Test / Ballotement Test.

Sturgill LP, Snyder-Mackler L, Manal TJ, Axe MJ. Interrater reliability of a clinical scale to assess knee joint effusion. journal of orthopaedic & sports physical therapy. 2009 Dec;39(12):845-9.