For a Few Maneuvers More

Sam is a fit-looking middle-aged gentleman of medium build. He does not have any significant abdominal adiposity and has a BMI of 25.

When you examine Sam's knees, you note that range of motion is, in general, quite good with mild limitation to flexion on the left knee.
In addition, Sam reports a bit of "tightness" and discomfort on taking his left knee between flexion and extension.

There were no definite areas of tenderness, but Sam found palpation of the joint lines on the left knee uncomfortable.

On further examination, you find a moderately-sized effusion of the L knee.