Hip

Question 1

What is the purpose of taking the actual leg length?

Answer 1

We’re looking for a hip joint to long bone deficiency

Question 2

How do we perform actual leg length?

Answer 2

Patient lies supine with feet together. Doctor measures from apex of ASIS to center of medial malleolus

Question 3

What is a positive finding of Actual Leg Length?

Answer 3

Difference of more than 6mm

Question 4

How does Apparent Leg Length differ from Actual Leg Length?

Answer 4

Apparent is looking for a spinal or pelvic subluxation due to the fact that we’re incorporating L3-L5 discs.

Question 5

What is the procedure for Apparent Leg Length?

Answer 5

Patient is supine with feet together. Doctor measures from umbilicus to center of medial malleolus.

Positive findings are a difference of more than 6mm.

Question 6

What is the procedure for Allis’ Sign?

Answer 6

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.

Question 7

What are positive findings of Allis’ Sign?

Answer 7

Ipsilateral femoral leg discrepancy potentially due to hip fracture, hip dislocation, or protrusion acetabuli

Question 8

What is another name for Allis’ Sign?

Answer 8

Galeazzi’s Sign

Question 9

What is the procedure for Anvil Test?

Answer 9

Patient is supine. Doctor stands at foot of table, elevates a straight leg and hits the bottom of the heel with a clenched fist.

Question 10

What is the purpose/findings of Anvil Test?

Answer 10

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

Question 11

What is the purpose of Gauvain’s Sign?

Answer 11

Check for AVN, infection, fracture, or gout

**NOTE: this test is performed on kids and adolescents

Question 12

What is the procedure for Gauvain’s Sign?

Answer 12

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.

Question 13

What are findings of Gauvain’s Sign?

Answer 13

Pain in the hip
Ipsilateral contraction of abdominal muscles
Referred pain to the groin or anterior thigh

Question 14

What is the purpose of Hip Telescoping Test?

Answer 14

Checking for hip dislocation or hip dysplasia

Question 15

What population has the highest incidence of hip dysplasia?

Answer 15

Mediterranean and Scandinavian Women

Question 16

What is the procedure for Hip Telescoping Test?

Answer 16

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.

Question 17

What are positive findings during Hip Telescoping Test?

Answer 17

Excess joint play

Palpable joint clicking

Question 18

What does “Fabere” stand for in “Patrick-Fabere Test”?

Answer 18

Flexion
Abduction
External Rotation
Extension

Question 19

What is the procedure for Patrick’s Test?

Answer 19

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

Question 20

What is the purpose of Patrick’s Test?

Answer 20

Looking for hip pathology:
OA 
DJD
RA
SCFE
AVN
Fx
Strain/sprain

Question 21

What are positive findings during Patrick’s Test?

Answer 21

Pain in the hip

Inability to perform the test

Question 22

What is the procedure for Ober’s Test?

Answer 22

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

Question 23

What are positive findings for Ober’s Test?

Answer 23

Affected thigh will remain abducted and may be painful, or may drop with a spastic jerk (clonus)

Indicative of tight IT band or TFL

Question 24

What is the procedure for Thomas Test?

Answer 24

Patient is supine and actively pulls unaffected knee to chest while keeping other leg straight on the table.

Question 25

What is the purpose of Thomas Test? What are positive findings?

Answer 25

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

Question 26

What is the procedure for Trendelenburg’s Test?

Answer 26

Patient stands on affected foot and raises unaffected foot off the ground. Doctor stands behind patient and observes for patient unleveling.

Question 27

What is the purpose/findings of Trendelenburg’s Test?

Answer 27

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

Question 28

What is the most common cause of Trendelenburg’s sign?

Answer 28

Muscular Dystrophy

Question 29

What is the procedure for Ortolani’s Test?

Answer 29

Patient lies supine. Doctor grasps both thighs at level of lesser trochanter, then flexes and abducts thighs bilaterally.

Question 30

What patient population do we perform Ortolani’s Test on?

Answer 30

Infants

Question 31

What is the purpose/findings of Ortolani’s Test?

Answer 31

Looking for congenital femoral dislocation or instability

+ findings = palpable click/clunk