Hip Flashcards
What can be viewed from the front in a hip exam?
- Scars
- Pelvic tilt
- Quadriceps wasting
- Foot deformity
- Head in middle of pelvis between both legs?
- Trunk alingment
What can be viewed laterally in a hip exam?
- Lumbar lordosis (normal/hyperlordosis?)
- Pelvic tilt: normal to be tilted forward
- Hips/knees/ankles
What can be viewed from the back in a hip exam?
- Scoliosis
- Gluteal wasting
- Pelvic tilt (pelvis level?)
- Spinal scars
- Spina bifida
- Paraspinal muscles
Tests on patient stood up in hip exam
- Lean forward and touch toes w/ thumb and finger on 2 vertebrae
- Feel down spine - any pain?
- Arms crossed on chest and twist around
- Arms down side, run hand down all the way side to knee
- Tremlemburg test
What does getting patients to put arms crossed on chest and twist around testing?
- Lower back pain? spinal problem
- Hip pain? Hip arthritis
- Lack of spinal movement vs lack of hip movement
What is checked for in arms being run down the side of the leg?
- Lateral spine movement
- Pain/end of range pain?
Describe trulemberg
- Bend knee, stand on one leg
- Hold both hands
- Feel them pushing down more on one than the other
- Positive: will push down on/lean towardsunaffected side
Steps of palpation lying down
- Arms across chest
- Palpate ASIS
- Around greater trochanter
- Feel hip joint
How to find the hip joint?
Line down from the ASIS
Line across from greater trochancter
Where they cross= slightly higher = hip jont
Describe Trendelenburg sign
- Bend knee, stand on one leg
- Hold both hands
- Feel them pushing down more on one than the other
- Positive: will push down on/lean towardsunaffected side
Movements done with patient lying down (7)
- Flexion : knee into chest
- Thomas test : flex unaffected hip’s knee, put hand under spine to keep lumbar lordosis flattened, - contralateral leg should be flat on bed
- Flex knee then do internal rotation and external rotation in flexion
- Whole leg out: adduction and abduction with hand on contralateral iliac crest
- Measure true length
- Measure apparent length
- Check ankle force “don’t let me push it”/pulses/sensations
Abnormal Thomas test (2)
- Affected thigh raises off bed
- Suggests fixed flexion deformity in affected hip
Movements with patient prone (3)
- Place a hand on pelvis to assess for movement
- Extension: one leg at a time
- Flex knee= external rotation and internal rotation in extension
Normal ROM of passive hip extension
10-20
Normal ROM of passive hip external rotation
45 degrees
Normal ROM of passive hip extension
10-20 degrees
Normal ROM passive hip flexion
120 degrees
Normal ROM hip abduction
45 degrees
Normal ROM hip adduction
30 degrees
When should Thomas test not be performed?
In patients with hip replacements - can cause dislocation
