Musculoskeletal (MSK) Knee Practice Test

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What is a grade of Trace on the Brush/Stroke Test?

No wave produced on downstroke

Small wave on medial side with downstroke

The test detects even a small amount of knee fluid by how it shifts when you stroke the joint. When there’s a very small amount of effusion, a tiny wave appears along the medial side as you perform the downstroke. That subtle medial wave with the downstroke is what defines a trace finding. It signals minimal fluid in the joint, less than what would produce a larger bulge or more obvious sign. If there were no wave, that would suggest no detectable effusion; a larger bulge on the medial side would indicate more fluid; and a description like fluid returning to the medial side after an upstroke points to a different pattern not used for the trace grade.

Larger bulge on medial side with downstroke

Effusion spontaneously returns to medial side after upstroke

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