Hip Flashcards
1
NOTE: Can be examined alongside lumbar spine (both hips and lumbar)
look
feel
move - bend forward, bend back, bend one arm down leg on side
special test - tape measure (10 and 5cm above and below posterior iliacs and then bend forward
may only ask right hip and lumbar spine eg
“Today ive been asked to examine your hips, this will inovle watching you walk, lookiong at the hip joints, feeling around both hip joints and then assessing movement in both hips. You in any pain at all?
can be asked on its own as well btw
-When examining the hip, the patient should be wearing their underpants but should remove
their trousers, socks and shoes.
2
ASSESS GAIT then
inspect from front - take a longggg look, everywhere
3
inspect from back
4
lie them down
inspect groins and thighs - scars etc
MS - Lie patient on bed. Inspect for scars in the groin, anterior and lateral thighs. If possible, roll the patient onto each side to inspect the gluteal regions
5
Measure leg in 2 places - sternum and iliac spine to inside malleolus
Measure xiphiSTERNUM to the medial malleolus of each leg
Then measure from the anterior superior iliac spine to the medial malleolus
6
PALPATE
-ask if any pain in hip before you start
-Assess the temperature on upper thigh and the
greater trochanter. Compare both sides
-Palpate the greater trochanter for trochanteric bursitis
just have a general feel 4 or 5 times around the hip and down top of the femur
7
ASSESS ROM
ACTIVE
-Active hip flexion
“ok and now for some movements. if you could just bring your right knee up towards your chest as far as you can.. (wait)…and bring it back down… and same on the other side”
ACTIVE ABduction and ADDuction
“and if you could lift your leg up and put it out to the side for me…. and if you could move it so its infront of the other foot”
8
PASSIVE
Hip flexion
“I’m now going to move your legs for you, just stay as relaxed as possible”
Hip flexion - bring knee up and back down
9
Passive -
Internal and external rotation of the hip
bring knee back up (keeping knee in one position) and this time with one hand on ankle, twist externally and then internally
10
Passive hip abduction and adduction
reaching arm hold their other side, pick up leg by ankle abduct and adduct their hip
ROM is 45
12
Turn them over and assess active ROM of leg behind
In a young patient assess the active ROM of extension with the patient lying prone.
Normal range is 10-30°
13
Thomas’ test
- place hand under bottom of spine
- place other hand under their knee/top of thigh
- flex hip again bringing knee up
- look at other thigh (shouldnt raise up off the bed - make obvious to examiner that youre looking at other thigh )
- repeat with the other leg
14
Trendelenbergs sign
-get person to stand up
-place either hands on the side of the patient (iliac crest)
-get person to stand on one leg (watch your hands)
“and stand on your right leg for me”
-and now stand on your other leg for me
