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
what is the quadrant (Souring) test
- Examiner flexes and adducts patient’s hip so hip faces patient’s
opposite shoulder and resistance to movement is felt - Slight resistance is maintained – patients’ hip is taken into abduction
while maintaining flexion in an arc movement
Positive => as movement is performed, examiner should look for any
irregularity in movement (bumps, pain, apprehension)
what is the finding for quadrant (souring) test
Hip pathology – OA or bursitis
what is the functional leg length discrepancy
- Patient lying supine with hips and knees flexed
- Examiner stands at patient’s feet and palpates distal aspect of
medial malleoli with the thumbs - Patient lifts pelvis from table and returns to starting position
- Examiner passively extends patient’s legs and compares position
of the malleoli using borders of thumb
Positive => thumbs are different levels
what is the finding for functional leg length discrepency
Functional leg length discrepancy
what are the special test for groin strain
resisted and passive ROM
what are the special test for hamstring strain
resisted and passive ROM
what are the special test for snapping hip
- Fabere
- Gaenslens
- thomas test
- yeomans
- obers
- obers modified
what are the special test for acetabular labral tear
- impingement test
- Resisted SLR
- Faebere
what are the special test for Hip DJD
- scour test
- Fabere
