Examination of the Hip Flashcards
What should be observed in standing (8 points)?
Posture of spine and LL
- spinal curves
- position of pelvis
- skin creases
- varus/valgus deformity
- foot posture
- soft tissues - quality and colour of skin, swelling, bruising, discolouration, scaring
- Ease of weight baring
- Signs of leg length discrepencies
What should be observed in movement?
Sit to stand - internal rotation or adduction of femur
Gait - stride length, stance time, WB ability
What should be observed in supine (5 points)?
Leg position from bottom and side of the plinth
- gene valgum/varus
- femoral or tibial position
- patella positioning
- muscle wasting
- position of heels
What movements should be assessed in hip aROM?
flex, abduct, adduct, MR, LR in supine
Ext in side ly
Why may aROM differ from pROM?
pain, muscle weakness
What adjacent joints COULD be tested in a hip exam?
Lx flexion, extension, lateral flexion
SIJ provocation tests
Knee - flex and ext
Why would testing the SIJ or Lx spine be appropriate?
Problem with the hip can cause secondary changes in Lx spine - lordosis
Why would testing the knee joint be appropriate?
FFD in the knee can cause altered gait and abnormally load the hip
Why would isometric testing be used?
To test muscles overlying areas of pain as the muscles could refer pain to the area
If there is too much pain, limiting ROM
How to document isometric testing?
Good contraction against firm resistance
Why is isotonic muscle testing used?
To differentiate between true muscle weakness and pain inhibited muscle contraction
What muscle groups should be tested?
Hip flexors, abductors, adductors, MR, LR and extension
How to measure isotonic strength?
Using MRC
What are the special tests for hip (7 points)?
- Leg length
- Thomas test
- Modified Thomas test
- FABER
- FADIR
- Trendelenburg
- Muscle length testing of hamstrings and quads
What is the appropriate AM used for the hip?
Longitudinal caudad of the hip
