HIP EXAM

Question 0

Feel?

Answer 0

Hip

• tenderness
• warmth

Apparent leg length (medial maleolis to umbilicus) vs true leg length (MM to ASIS)

Palpate greater trochanter (Trochanteric bursititis)

Question 1

What to look for?

Answer 1

Standing rotate 90 degrees:
FRONT: scars/pelvic tilt/quadricep wasting/comfortable
SIDE: lordosis
BACK: gluteal wasting

GAIT

• smoothness/turning
• antalgic/trendelenburgs

trendelenbergs test (hold the pt ASIS, bend contra lateral knee -> gluteal abductin muscles compensate), suggests contralateral abductor muscle weakness.

Lying: symmetry and rotation (one leg shortened, externally rotated = FNOF)

Question 2

Move?

Answer 2

Flexion - bring knees towards chest
Abduction - keep leg straight, move away from your midline)
Addiction - keep leg straight and nice it across the midline
Internal rotation and external rotation (passive)

Question 3

Special tests?

Answer 3

Thomas’ test

1) left hand under pt spine
2) passively flex both legs

Lumbar lordosis should be flattened
Pt needs to then extend hip which is bring assessed. If unable to -> fixed flexion deformity of the hip (OA)

SCHABER TEST
Flexion abduction and external rotation. Apply pressure.
Positive test is pain, SI or hip pathology either labrum or arthritis.

Question 4

Common pathology?

Answer 4

Trochanteric bursitis: pain over greater trochanter

Hip osteoarthritis: pain, reduced ROM (internal rotation lost first), positive THOMAS and TRENDELENBURGS in advanced OA