Hip Flashcards
What is the purpose of taking the actual leg length?
We’re looking for a hip joint to long bone deficiency
How do we perform actual leg length?
Patient lies supine with feet together. Doctor measures from apex of ASIS to center of medial malleolus
What is a positive finding of Actual Leg Length?
Difference of more than 6mm
How does Apparent Leg Length differ from Actual Leg Length?
Apparent is looking for a spinal or pelvic subluxation due to the fact that we’re incorporating L3-L5 discs.
What is the procedure for Apparent Leg Length?
Patient is supine with feet together. Doctor measures from umbilicus to center of medial malleolus.
Positive findings are a difference of more than 6mm.
What is the procedure for Allis’ Sign?
Patient lies supine with knees/hips flexed and feet flat on table. Doctor stands at food of table to observe knees for height discrepancy, then observes from the side to look for one knee being anterior to the other.
What are positive findings of Allis’ Sign?
Ipsilateral femoral leg discrepancy potentially due to hip fracture, hip dislocation, or protrusion acetabuli
What is another name for Allis’ Sign?
Galeazzi’s Sign
What is the procedure for Anvil Test?
Patient is supine. Doctor stands at foot of table, elevates a straight leg and hits the bottom of the heel with a clenched fist.
What is the purpose/findings of Anvil Test?
Heel pain = calcaneous, tibia, or fibula fracture
Hip pain = arthritis, infection, femoral neck fracture
**Look for pain anywhere in the kinetic chain from heel to acetabulum
What is the purpose of Gauvain’s Sign?
Check for AVN, infection, fracture, or gout
**NOTE: this test is performed on kids and adolescents
What is the procedure for Gauvain’s Sign?
Patient lies with affected side up. Doctor places one hand on abdominal muscles, other hand grasps just above the ankle, abducts the leg and internally and externally rotates the thigh.
What are findings of Gauvain’s Sign?
Pain in the hip
Ipsilateral contraction of abdominal muscles
Referred pain to the groin or anterior thigh
What is the purpose of Hip Telescoping Test?
Checking for hip dislocation or hip dysplasia
What population has the highest incidence of hip dysplasia?
Mediterranean and Scandinavian Women
What is the procedure for Hip Telescoping Test?
Patient is supine, doctor passively flexes the hip and knee to 90 degrees. Doctor grasps calf and thigh on affected side with one hand and places other hand on back of thigh just above the knee, then pushes the femur into the table and distracts femur from table.
What are positive findings during Hip Telescoping Test?
Excess joint play
Palpable joint clicking
What does “Fabere” stand for in “Patrick-Fabere Test”?
Flexion
Abduction
External Rotation
Extension
What is the procedure for Patrick’s Test?
Patient is supine. Doctor stands on unaffected side, patient crosses their leg to “figure 4 position”. Doctor stabilizes opposite ASIS and applies downward pressure on knee of affected side
What is the purpose of Patrick’s Test?
Looking for hip pathology: OA DJD RA SCFE AVN Fx Strain/sprain
What are positive findings during Patrick’s Test?
Pain in the hip
Inability to perform the test
What is the procedure for Ober’s Test?
Patient lies with affected side up. Doctor stands behind patient and stabilizes pelvis, then uses other hand to abduct and extend the thigh and the hip (while knee is bent to 90 degrees). Doctor then slides hand from knee to ankle while keeping the knee bent, allowing the knee to adduct
What are positive findings for Ober’s Test?
Affected thigh will remain abducted and may be painful, or may drop with a spastic jerk (clonus)
Indicative of tight IT band or TFL
What is the procedure for Thomas Test?
Patient is supine and actively pulls unaffected knee to chest while keeping other leg straight on the table.
What is the purpose of Thomas Test? What are positive findings?
Checking for flexion contracture or shortening of the iliopsoas on affected side.
+ findings: L-spine maintains lordosis; patient is unable to keep affected thigh flat on table
What is the procedure for Trendelenburg’s Test?
Patient stands on affected foot and raises unaffected foot off the ground. Doctor stands behind patient and observes for patient unleveling.
What is the purpose/findings of Trendelenburg’s Test?
Looking for paralysis or weakness of hip abductors on affected side (glute med) or hip dysplasia
+ finding = high iliac crest on supported leg, low iliac crest on the lifted leg
What is the most common cause of Trendelenburg’s sign?
Muscular Dystrophy
What is the procedure for Ortolani’s Test?
Patient lies supine. Doctor grasps both thighs at level of lesser trochanter, then flexes and abducts thighs bilaterally.
What patient population do we perform Ortolani’s Test on?
Infants
What is the purpose/findings of Ortolani’s Test?
Looking for congenital femoral dislocation or instability
+ findings = palpable click/clunk
