Hip Exam

Question 1

what must be asked before starting a hip examination?

Answer 1

have you had a hip replacement? If yes internal rotation, adduction and flexion greater than 90° should be avoided due to risk of dislocation

Question 2

hip examination, inspection

Answer 2

scars pelvic tilt, wasting, foot deformity, lumbar lordosis, scoliosis, gluteal wasting

Question 3

what begins a hip examination?

Answer 3

Gait

Question 4

measuring leg length

Answer 4

apparent leg length, from umbilicus to tip of medial malleolus. True leg length ASIS to tip of medial malleolus.

Question 5

in what position do you examine active movement?

Answer 5

please hand under lumbar spine to detect masking of hip movement by pelvis/lumbar spine

Question 6

what questions to ask on active movement

Answer 6

Bring your need to wards your chest

Question 7

passive movement of the hip joint

Answer 7

one. Flexion, normal range of movement 120°. Internal rotation, hip and knee joint flexed at 90°, normal range of movement 40°. External rotation normal range of movement 45°. Abduction, while stabilising contralateral iliac crest, use other hand to abduct hip until you feel pelvis beginning to tilt. At duction, while stabilising contralateral iliac crest, use other hand to add up to patience leg across midline as far as possible. Range of movement 30° come. Then hit extension, please hand and pelvis to assess movement, normal range of motion 10 to 20°

Question 8

examination special tests

Answer 8

Thomases test, place hand under patients spine. possibly flex both legs as far as possible, and the lumbar lordosis should now be flattened. Ask patient to fully extend hip you are assessing. Incomplete extension suggest fixed flexion deformity in at the hip joint. Do not perform on patients with hip replacement.

Trendelenberg test, please hands on iliac crest on side of pelvis asked patient to stand on one leg for 30 seconds observed to see if pelvis falls.test is abnormal if pelvis falls on the side with the foot off the ground, suggesting week hip abductors on contralateral side of the pelvis

Question 9

completing a hip examination

Answer 9

Full neurovascular examination of both limbs, examine joint above and below, considering further imaging is indicated including x-ray weight-bearing, CT or MRI