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The clinical examination of the child or adolescent with a knee injury or pain can vary based on the age of the patient as well as the acuity of the problem. When pediatric patients present with thigh or vague knee pain, the importance of the hip examination cannot be overemphasized. Evaluating the uninjured extremity first is particularly valuable to building trust and confidence with a scared, nervous patient. Having the patient describe and point to locations of symptoms can assist in prioritizing physical exam maneuvers as creating pain through exam will limit later exam compliance. There are four primary elements of the exam: observation, palpation, static stability examination, and dynamic assessment. This review article will summarize physical exam techniques and pertinent findings for meniscus, ligament, and patellofemoral pathology.