A patient arrives with a swollen knee from a skiing injury. What assessment should be performed first?

In the case of a swollen knee following an injury, the initial focus should be on assessing the joint's overall integrity and function. Performing a tibiofemoral joint play assessment is essential because it helps evaluate the passive mobility of the joint and the surrounding structures, which can provide important information about potential joint stability or any restrictions present.

This assessment can reveal whether there is any joint effusion, ligamentous injury, or other conditions affecting the knee's mechanics. Identifying these issues is crucial before conducting more specific strength or range of motion assessments, as they might exacerbate pain or injury if the joint is not stable enough.

Other assessments, such as palpation or evaluating range of motion, are also important but would typically follow the joint play examination in the order of assessment, as understanding the basic joint mechanics is key to interpreting results accurately from other tests. Thus, starting with the tibiofemoral joint play ensures a comprehensive understanding of the knee's condition following the injury.