Hip Flashcards
Scour test
The patient is positioned in supine on the plinth. The therapist stands on the side of the leg to be tested. The affected limb is placed in adduction and a compression force is applied and maintained through the femur through a range of 70-140 degrees of hip flexion. The test is repeated in abduction. A positive test is a reproduction of the patient’s worst pain that they came with into the clinic.
Interpretation
The test is considered positive if the patient has any pain. The test is also positive if the therapist can feel any crepitus or if there is a leathery end feeling or if there’s a loss in ROM.[7][2]
The test is considered negative if you can go from flexion-adduction to flexion-abduction in an arch, a normal ROM and with a normal end-feeling.[7][1]
This test works by scouring the femoral acetabular joint for pathology. The compression of the femur, through the various ranges, stresses the bone, labrum, cartilage, ligaments, etc. While this test has been labeled as the “hip clearing test,” due to the low diagnostic accuracy, it should not necessarily be used as such. Consider the results of the rest of your exam when trying to determine the pathology.[9]
Dysfunction
A positive Hip Quadrant test is an indication that there might be arthritis, an osteochondral defect, avascular necrosis, joint capsule tightness and/or an acetabular labrum defect[11]. This test also detects if the patients hip can move through the full range of motion.[10]
Evidence
Th hip quadrant test does not give us any significantly useful information. Due to the wide range of structures that can be stressed, its results should be interpreted with caution. No validity or reliability studies could be located for its diagnostic validity.
Minimal data is available on the significance of the Hip Quadrant alone. However, the American College of Rheumatology provide an alternative method for the diagnosis of hip OA.
There are 2 cluster diagnoses which are:
Cluster 1:
Pain in the hip
<115 degrees of hip flexion
< 15 degrees of hip IR
Cluster 2:
Pain with hip IR
> 60 minutes of AM stiffness
> 50 years old[12]
If at least 4 of 5 variables were present, the positive LR was equal to 24.3 (95% confidence interval: 4.4-142.1), increasing the probability of hip OA to 91%.[12]
Related articles
what can the FABER test detect?
The following findings of a positive FABER test may help to guide your clinical diagnosis;
Sarcoiliac Joint Pain on external hip rotation Sacroiliac Joint Dysfunction Sacroiliitis Groin Pain on external hip rotation Iliopsoas Strain or Iliopsoas Bursitis Intraarticular Hip Disorder Hip Impingement (femoral acetabular impingement) Hip Labral Tear[8] Hip loose bodies Hip chondral lesion Hip Osteoarthritis[9] Posterior Hip Pain on external hip rotation Posterior Hip Impingement Evidence
Sign of the Buttock
‘Sign of the buttock’ term was coined by Cyriax. It actually means 7 signs rather than a single one.The sign of the buttock is part of a combination of findings which indicates serious gluteal pathology posterior to the axis of flexion and extension of the hip.
It helps to determining whether a patient’s buttocks pain has its origin in the buttock as a local lesion or is referred from the hip, sciatic, nerve or hamstring muscles. It is considered being a red flag and requires returning the patient to the physician for further investigation
The patient suffers from gluteal pain, which may or may not spread down the leg Colour changes and swelling are not expected at the hip because it is such a deep joint, but they may be associated with trauma, bruising and abrasions. If redness and swelling are present in the buttock area without a history of trauma, the ‘sign of the buttock’ may be suspected.
7 signs:
Buttock large and swollen and tender to touch
Straight Leg Raise (SLR) limited and painful
Limited trunk flexion
Hip flexion with knee flexion limited and painful
Empty end feel on hip flexion
Non capsular pattern of restriction at hip (flex,abd,IR)
Resisted hip movements painful and weak esp hip extension
