Hip Flashcards
what is the trendelenburg test?
- Stand behind patient and observe iliac crest/top of hip of unsupported
leg - Have patient stand on one leg – normally gluteus medius muscle on
supporting side should contract when leg leaves ground preventing
unsupported hip from dropping (instability) - Pelvis should elevate on unsupported side
Positive => pelvic on unsupported side remains in position or descends
what are the findings of trendelenburg test?
Weak or non-functioning gluteus
medius muscle on supported side
(+) pelvic lateral tilt – weak hip
abductor muscles (glute med),
neurologic or muscle conditions
deficit
(+) pain in SI on support leg – SI
joint pathology
what is yeoman sign
- Patient lying prone
- Examiner lifts knee to 90 degrees and extends hip
Positive => pain in SI joint or lumbar region
what are the findings for yeoman sign
SI joint pain = pathology in anterior SI ligaments
Lumbar pain = lumbar involvement
Anterior thigh paresthesia = femoral nerve stretch
what is the sign of the buttock test
- Patient supine
- Examiner performs unilateral SLR test
- If restriction or pain found, examiner flexes patients’ knee while
holding thigh in same position - After knee is flexed – examiner tries to increase the flexion of hip
- Negative would allow for more hip flexion that is painless (when knee
is bent) and would indicate lumbar spine or tight hamstring issues of
pain
Positive => cannot increase hip flexion
what are the findings of the sign of the buttock test
Pathology in buttock – bursitis,
tumour, or abscess
what is the noble compression test
- Patient supine with knee flexed to 90 degrees
- Examiner applies pressure with thumb to lateral femoral condyle or 1-2 cm proximal to it
- While maintaining pressure patient slowly extends knee
Positive => pain at approximately 30 of flexion
what is the finding for noble compression test
(+) – pain over lateral femoral
epicondyle or palpable tendon
snapping => iliotibial band
friction syndrome
what is the thomas test
- Patient supine with pelvis level and square to trunk
- Stabilize pelvis by placing hand under lumbar spine and flex both
hips, bringing knees to chest - Feel for flattening of lumbar spine – from this point on only hip
flexion will allow leg to move - Patient extends one leg and lets it rest on the table
Positive => leg remains flexed and will not lie flat on the table
what is the finding for the thomas test
Tight hip flexors (same side as leg up) – iliopsoas
what is the piriformis test?
- Patient lying on side; involved side up
- Flex upper hip (testing side) 60-90
- Flex knee 90
- Examiner stabilizes hip with free hand; place downward pressure with
other hand
Positive => pain in piriformis area or recreation of symptoms
what is the findings for the piriformis test?
Tight piriformis or piriformis
syndrome
(+) radicular leg or buttock pain –
piriformis syndrome, piriformis
myospasm
what is the piriformis length test?
- Patient lying prone with knees slightly apart
- Flex both knees to 90
- Slowly lower the legs away from midline while keeping knees
together
Positive => decreased internal rotation (stretching of piriformis)
what is the findings for piriformis length test
Hypertonic (shortened, tight) piriformis
what is the pace abduction test
- Patient sitting with legs over table and knees close together
- Knees flexed to 90 and examiner places hands on lateral aspect of
knee joint bilaterally - Resist patients’ actions of external rotation (try to separate legs)
- Be sure to not overpower – match resistance
Positive => pain in piriformis area or recreation of symptoms (external
rotation)
what is the finding for pace abduction test
tight piriformis
what is the Ely’s test/ Nachlas test
- Patient lying prone
- Knee is flexed slowly, attempting to stretch quadriceps
Positive Ely’s => hip on ipsilateral side will spontaneously flex and hike up
Positive Nachlas => pain felt in front of thigh before full range is reached
(rectus femoris) OR pain in lumbar spine (lumbar spine)
what are the findings for Ely’s test/Nachlas test
Ely’s
(+) knee flexion pain – femoral
nerve or root compression, quad
muscle contracture
(+) hip extension pain – femoral
nerve or root compression,iliopsoas muscle strain or
inflammation
Nachlas – tight rectus femoris or
lumbar spine
(+) local pain – SI/lumbar/knee
ligament sprain, quad strain
(+) radiating pain – femoral nerve
what is the Faber’s test
- Patient lying supine
- Examiner places foot of involved side on the opposite knee
- Examiner applies over pressure downwards on flexed knee and
opposite side of ASIS
Positive => increased pain in SI joint or hip joint
what is the findings for Faber’s test?
Pathology of SI joint or hip joint
what is the Hibb’s test
- Client lying prone with knee flexed to 90 degrees
- Examiner internally rotates hip by pulling the ankle laterally while
stabilizing sacroiliac joint on opposite side
Positive => pain or reduced mobility on testing side at the sacroiliac joint
what is the findings for the Hibb’s test
Posterior sacroiliac ligament
pathology
(+) sacroiliac pain – SIJ pathology
(+) hip pain – hip lesion
(+) radicular pain – piriformis entrapment of sciatic nerve
what is the Gaenslen’s test
- Patient lying supine
- Ask patient to bring both legs into chest
- Shift patient to side of the table so one buttock is over edge of table
- Drop unsupported leg over the edge while opposite leg remains flexed;
examiner can provide over pressure to help stretch leg
Positive => pain in SI joint or pain in hip on the side of the lowering leg
what is the findings for Gaenslen’s test
SI joint pathology or hip pathology
