Hip Exam

Question 1

what would you look at in a hip exam?

Answer 1

stance?, look from side + behind
gait + turning + shoes
leg length: apparent - tape measure from xiphisternum to medial mal (can be influenced by pelvic tilt), true - tape measure from ASIS to medial mal
if there is true leg length discrepancy - place hand over tibial tuberosities (femoral if hand dips down towards shortened) place hand over suprapatellar (tibial if hand dips toward shortening)

Question 2

what would you palpate in a hip exam?

Answer 2

joint temperature + any tenderness around the greater trochanter

Question 3

what would you move in a hip exam?

Answer 3

ACTIVE
abduction - leg straight move outwards
adduction - leg straight bring inwards
flexion - bring knee to chest
PASSIVE
abduction, adduction, flexion and extension (in young patient in prone)
int rotation - in extension and then knee flexed, rotate foot laterally
ext rotation - in extension and then knee flexed, rotate foot medially

Question 4

what happens in thomas’ test

Answer 4

hand under lumbar spine
passively flex one leg the contralateral leg should stay flat
if leg moves - affected - fixed flexion deformity

Question 5

what happens in trendelenburg’s test

Answer 5

stand on one leg
observe hip
if contralateral hip drops - that side has weak abductors

Question 6

what would you offer to complete hip exam

Answer 6

examine lumbar spine and knee joint
neurovascular exam on lower limb