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
