Hip Assessment

Question 1

Test for posterior impingement and labral tear

Answer 1

FADIR

Question 2

FADIR

Answer 2

Indication:
Femoro-acetabular impingement.
Labral tear and hip joint pathology and instability

Procedure:
- supine
- starting position: passively fully flex , Adducts, and internally rotates the hip
- then laterally rotate , abduct, and extend hip

Positive sign:
groin pain
Apprehension
Reproduction of symptoms
Crepitus (with or without pain)

Question 3

Anterior labral tear test

Answer 3

Indication:
Hip labral tear

Procedure:
- supine
- starting position: fully flex, laterally rotate , and abduct hip FABER
- then extend, medially rotate, adduct the hip (end position)

Positive:
Pain (with or without click)

Question 4

Patrick’s test

Answer 4

Indication:
- Hip or SI joint pathology

Procedure:
- supine
- place test leg on top of the good knee
- slowly lower test knee towards examining table

Positive:
- pain at END range = SI joint
- pain and limited movement at MID range = hip pathology or iliopsoas spasm

Question 5

Thomas test

Answer 5

Indication :
Hip flexion contracture (iliopsoas)
ITB tightness

Procedure:
- supine
- therapist flexes on of the patient’s hips bringing knee to chest to flatten out lumbar spine
- patient holds flexed hip against chest

Positive:
Patient straight leg rises off table = hip flexion contracture
Patient abducts and externally rotates straight leg = ITB tightness

Question 6

Ober’s test

Answer 6

Indication:
TFL/ITB tightness

Procedure:
- patient lies on his side with test leg uppermost
- Stabilize the pelvis and passively abduct and extend upper leg with knee straight
- slowly lowers the upper leg

Positive :
Leg remains abducted and doesn’t fall to the table .

Question 7

Trendelenburg’s test

Answer 7

Indication:
Stability of hip and abductors strength (gluteus medius and minimus)

Procedure :
Patient stands on one leg

Positive :
Pelvis on non-stance side drops

Note : during gait, side trunk flexion occurs towards the involved side during stance phase on affected extremity.

Question 8

Kendall test

Answer 8

Indication:
Tight rectus femoris

Procedure :
- Supine with knee bent 90° over the edge of the table
- Patient flexes one knee onto chest and holds it

Positive :
Bent knee is extended .

80 to 90° knee flexion = normal
< 80 ° knee flexion = tight rectus femoris

Question 9

Ely’s test

Answer 9

Indication:
Tight rectus femoris

Procedure :
- Prone
- Passively flexes the patient’s knee

Positive:
Hip on the same side, spontaneously flexes /rises

Question 10

Piriformis test

Answer 10

Indication:
Piriformis tightness

Procedure :
- sidelying with tested leg uppermost
- Patient flexes the tested hip to 60° with knee flexed
- stabilize hip with one hand and apply downward pressure to knee

Note:
Why not 90° hip flexion ? Because the action of the Piriformis changes from lateral rotator to abductor

Note: alternative method = figure of 4 (more sensitive and accurate)

Positive :
Pain in buttock

Question 11

Craigs test

Answer 11

Indication:
Hip anteversion angle

Procedure :
- prone with knee flexed to 90°
- Palpate the posterior aspect of greater trochanter
- mediately and laterally rotate hip until greater trochanter is parallel with table.

Positive :
Normal = 8 to 15°

Note : greater trochanter naturally faces upwards

Question 12

joint play movements. Assessment of accessory movements.

Answer 12

Traction
Compression
Lateral distraction
Quadrant test (lateral to medial and medial to lateral)