hip exam Flashcards
what clinical signs to look for in a hip exam
body habitus, scars, wasting of muscles
what objects to look for in a hip exam
walking aids and prescription charts
anterior inspection of the hips
scars, bruising, swelling, quadriceps wasting, leg length discrepinancy, pelvic tilt
unilateral swelling of the hip may indicate
effusion, inflammatory athroplathy and septic arthritis
leg length discrepancy can be du eto
fracture, degenrative joint disease, surgical removal of bone, trauma to epiphyseal end plate prior to skeletal maturity
pelvic tilt can be due to
lateral pelvic tilt caised by scoliosis, leg length discrepancy or hip abductor weakness
lateral inspection of the legs can reveal
fixed flexion
what can a fixed flexion diformity suggest the presence of
contractires secondary to previous trauma , infammatory conditins and neurological disease
posterior inspection of the hips
scars and muscle wasting
after looking at the hips and legs what should you do next in a hip exam
ask the patient to walk
what is important to asses to indicate abnormal gait
soles of the patients shoes
trendelenburgs gate due to
superior gluteral nerve lesion or L5 radiculopathy
waddling gait due to
muscular dystrphy
what to do in a hip exam after asking the patient to walk
ask them to lie on the bed and inspect once more
what to do after the patient is lying down in a hip exam
feel temperature of the hip joints
what can increased temperature of a joint indicate
septic or inflammatory arthritis
what to do after feeling temperature of hips in a hip exam
palpate the greater trochanter
what can tenderness of the greater trochanter mean
trochanteric bursitis
what to do after palpating the greater trochater of in a hip exam
measure apparent and true leg length
what is apparent leg length
from belly button to medial malleolsu
what is true leg length
measure from ASIS to medial malleolus
what leg should you move first
the normal leg
what to do after measuring leg length in a hip exam
place hand under lumbar spine and ask patient to bring knee to the chest
what is the normal range of motion for active hip flexion
120
what to do in a hip exam after active hip flexion
ask the patient to straighten their leg out so that its flat on the bed
what to do after the hip flexion in a hip exam
perform passive hip flexion
how to perform passive hip flexion
flex the patients leg flex the hip as far as you able making sure to observe for signs of discomfort
what to do after passive hip flexion
passive internal rotation
normal range for passive hip flexion
120
what to do in passive internal rotation of hip
flex the patients hip and knee joint to 90 degrees and then rotate the foot laterally
normal range of movement for passive internal rotation of hip
40
what to do after passive infernal rotation in a hip exam
external rotation
what to do in passive external rotation of hip
flex the hip and knee to 90 degrees then rotate the foot medially
normal range for passive external rotation of the hip
45
what to do after passive hip external rotation
passive hip abduction
how to perform passive hip abduction
with the patients legs straight and flat on the bed use one hand to hold the ankle and one on the opposite iliac crest and move the ankle laterally
normal range of movement for passive hip abduction
45
what to do after passive hip abduction
passive hip adduction
normal range of movement for passive hip adduction
30 degrees
what to do after passive hip adduction
passive hip extension
how to perform passive hip extension
ask patient to lie on their tummy, use one hand to hold the ankle of the leg being assessed and the other hand on the pelvis and life up the leg
normal range of movement in passive hip extension
10-20
what is Thomas’s test used for
fixed flexion deformity
how to perform Thomas test
place hand below the lumbar spine and passively flex the hip of the unaffected leg as far as you are able to and observe the contralateral limb
what is a positive Thomas test
affected thigh raises off the bed suggesting a fixed flexion deformity
when not to perform Thomas test
in patients with hip replacements
what is trendelenburgs test used for
hip abductor weakness
how to perform the trendelenburg test
stand in front of the patient and ask then to place hands on ur forearms for stability ask patient tot and on one leg and look for lateral pelvic tilt
