![]() A palpated or audible tap indicates a "ballotable" knee and is consistent with at least a moderate amount of fluid.If there is an effusion, the patellar will bounce off the underlying bone (patella tap test). Next use the other hand to push to push on the patella. Method 2: Assess for fluid by placing one hand superior to the patella and with slight downward pressure milk the suprapatellar pouch which emptys into the knee joint.A medial aspect that does not bulge but tensely reflects lateral pressure is consistent with a large amount of fluid.A medial aspect that 'bulges' out after lateral pressure (positive "bulge sign") is consistent with a moderate amount of fluid.Commonly, no fluid will be appreciated. ![]() Then press firmly on the lateral aspect of the knee. ![]()
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