Hip and knee exam

Question 1

What is the difference between apparent and true leg length?

Answer 1

1)true leg lengh–> from ASIS to medial malleolus

–> this is seen to change in abduction or adduction deformities or scoliosis

true leg length discrepancy–> hip problem on the shorter side

2)apparent leg length–> umbilicus to medial malleolus

apparent leg length problem–> tilting of the pelvis

Question 2

What are the special tests for the hip exam?

Answer 2

• *1)Thomas test**
• -> patient supine, with other leg flat on table, flex knee to chest, look if other knee comes off the table

if other knee raises off the table–> flexure-contracture

2)modified thomas test–>

have patient in same position as for thomas test but scooted to end to table so their knees are approximately 4 inches off the table

do the same motions as the thomas test

if the thigh raises off the table, flex that knee

a) if the knee flexes easily–> iliopsoas is tight
b) if knee does not flex easily–>rectus femorais is tight