Hip Exam

Question 1

Four compartments of the hip:

Answer 1

Central, peripheral, lateral and psoas

Question 2

Central compartment components:

Answer 2

Labrum, ligamentum teres, articular surfaces

Question 3

Peripheral compartment components:

Answer 3

Femoral neck, synovial lining

Question 4

Lateral compartment components:

Answer 4

Gluteus medius/minimus, IT Band, Trochanteric bursae (Deep and Superficial)

Question 5

Psoas compartment components:

Answer 5

Iliopsoas insertion and bursae

Question 6

Central Compartment maneuvers

Answer 6

Log roll, labral loading, labral distraction, scour and apprehension (FABER), C-sign

Question 7

Log Roll is performed by:

Answer 7

patient supine, internal/external rotation of leg. Positive test is: PAIN

Question 8

Labral loading is performed by:

Answer 8

supine, flex hip/knee 90, physician force straight down into acetabulum of hip. Positive test is: PAIN

Question 9

Labral distraction is performed by:

Answer 9

supine, flex hip/knee 90, physician force straight up out of acetabulum of hip. Positive test is: relief of pain

Question 10

Scour is performed by:

Answer 10

supine, flex hip/knee 90, internal/external rotation of leg. Positive test is: PAIN.

Question 11

Apprehension/FABER for central compartment is performed by:

Answer 11

supine, flex hip/knee 90, ankle over other straight leg, physician force down normal to knee position. Positive test is: Pain/apprehension of exam

Question 12

Pathology of central compartment:

Answer 12

Labral tears, ligamentum teres disruption, osteochondral defects, joint mice/loose bodies, osteoarthritis, chondromalacia

Question 13

Signs/symptoms of peripheral compartment dysfunction

Answer 13

catching/locking, pain in hip with movement

Question 14

Pathology of peripheral compartment

Answer 14

Joint mice/loose bodies, impingment syndrome (Pincer and CAM type), synovitis

Question 15

Peripheral Compartment maneuvers

Answer 15

Log rolls, Ely’s test, Rectus femoris test

Question 16

Ely’s test is performed by:

Answer 16

supine, flex knee, testing rectus femorus. Test is positive if: Hip stays up off the table and ipsilateral hip flexion

Question 17

Rectus femoris test is performed by:

Answer 17

supine, flex hip at end of table. Drop one. Observe about 90 degree of knee flexion. If not then, loose body, pincer of acetabulum or CAM

Question 18

Lateral Compartment signs and symptoms

Answer 18

Weakness (difficulty climbing stairs), pain radiating down leg to knee, knee pain, instability

Question 19

Pathology of Lateral compartment

Answer 19

IT band syndrome, bursitis, rotator cuff tendonopathies (Glut medius/minimus)

Question 20

Jump sign tests for:

Answer 20

Bursitis

Question 21

Jump sign is performed by:

Answer 21

pressing on lateral aspect of hip above the glut medius. Positive test if PAIN/withdrawal

Question 22

List two IT BAND syndrome tests:

Answer 22

Straight leg and Ober’s test

Question 23

Straight leg is performed by:

Answer 23

supine, flex hip straight leg. If lateral pain at >15 degrees then positive for IT band syndrome

Question 24

Ober’s is performed by:

Answer 24

Recumbent position, IT band wants to be abducted. If abduct leg and leg stays up or lowers with a RATCHED motion, then positive Ober’s test

Question 25

Rotator Cuff pathology is tested via what three tests?

Answer 25

Piriformis Test, trendelenburg test, FABER

Question 26

Piriformis test is performed by:

Answer 26

supine, flex leg, one ankle over the other leg like in p90x glute stretch. Positive if pain or weakness (must compare to other side)

Question 27

Trendelenburg test is performed by:

Answer 27

raise one foot off ground, gluteus medius should contract to compensate for weight shift. If patient drops on lifted side, then weight bearing gluteus medius is NOT compensating for weight shit): positive if hip drop on lift foot side

Question 28

FABER for rotator cuff test is performed by:

Answer 28

supine, flex hip/knee, ankle over other leg. Physician hand on lateral side of knee. Patient pushes/adducts into physician’s hand. Weakness or pain are positive for pathology of rotator cuff

Question 29

Iliopsoas/anterior compartment signs and symptoms

Answer 29

Pain in anterior hip, medial groin, anterior deep thigh

Question 30

List three tests for iliopsoas/anterior compartment

Answer 30

FABER, Psoas Test, Thomas test

Question 31

FABER for iliopsoas test is performed by:

Answer 31

supine, ankle over leg, patient pushes up on physician’s hand. Weakness or pain with motion is indicative of iliopsoas compartment pathology

Question 32

Psoas Test is performed by:

Answer 32

supine, hip flexion. pain in anterior thigh is positive

Question 33

Thomas test is performed by:

Answer 33

supine, hug knees up, drop one off, checking to see if hip can be extended. If not then positive Thomas test and therefore tight iliopsoas test