Knee Stability and Movement Coordination Impairments: Knee Ligament Sprain: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association

. Author manuscript; available in PMC: 2011 Aug 21.

Published in final edited form as: J Orthop Sports Phys Ther. 2010 Apr;40(4):A1–A37. doi: 10.2519/jospt.2010.0303

Bulge Sign
ICF category	Measurement of impairment of body structure, knee joint
Description	The amount of fluid in the knee joint measured by visual inspection by clinician
Measurement method	The examiner, with 1 hand located superior to the patella, pushes the tissues (and possible fluid) inferiorly towards the patella. Keeping this hand in this position while holding pressure on these tissues, the examiner uses their other hand to press the medial aspect of the knee just posterior to the patellar edge to force any fluid within the joint laterally. While watching the medial joint area, the hand over this area is taken and used to press quickly along the lateral (ie, opposite) aspect of the knee, looking for a fluid wave to present medially.
Nature of variable	Nominal
Units of measurement	Absent Present
Measurement properties	Reliability coefficient of 0.97 ²⁷ in patients with knee osteoarthritis.
Instrument variations	Other effusion test can be used to assess knee effusion. ⁷⁶ In addition to visual inspection, knee effusion can be measured using a tape measure or perometer for knee circumference.^98,160