Hip Exam Flashcards
Hip Anatomy
Iliac Crest Anterior Superior Iliac Spine (ASIS) Greater Trochanter Pubic Tubercle Posterior Superior Iliac Spines (PSIS) Ischial Tuberosity
Hip Flexion (Knee Straight)
Illiopsoas, sartorius, rectus femoris, tensor fascia latae ms.
90°
Hip Flexion (Knee flexed)
Illiopsoas, sartorius, rectus femoris, tensor fascia latae ms.
120-135°
Hip Extension
Gluteus maximus m. and Hamstring ms.
15-30°
Hip Internal rotation
30-40°
Hip External Rotation
Sartorius, gluteus medius, gluteus maximus ms.
40-60°
Hip abduction with knee extended
Gluteus medius and minimus ms. Also gluteus maximus, sartorius, and tensor fascia latae.
45-50°
Hip adduction with knee extended
Adductor longus m.
20-30°
Patellar Tendon Reflex Nerve Root
L4
Achilles Tendon Reflex Nerve Root
S1
Palpable Pulses for LE
femoral, popliteal, posterior tibial, dorsalis pedis as.
Central Hip Compartment
Labrum, ligamentum teres, articular surfaces.
Peripheral Hip Compartment
Femoral neck, synovial lining
Lateral Hip Compartment
Gluteus medius, gluteus minimus, piriformis, IT band, trochanteric bursae
Anterior Hip Compartment
Illiopsoas insertion, illiopsoas bursae.
Log Roll
Roll the patient’s leg into internal and external rotation.
(+) Test: Pain
Indicates: Central or peripheral compartment pathology
C-Sign
Patient characteristically points to source of pain with two fingers or cups just above the trochanter with the thumb and index finger.
Indiates: Labral pathology
Labral Loading
Flex the patient’s knee and hip to 90°, load into the femur towards the innominate
(+) Test: pain
Indicates: Labral or cartilaginous pathology
Labral Distraction
Distract patient’s femur away from innominate
(+) Test: Improvement of pain.
Indicates: Labral or cartilaginous pathology
Scour
Flex and externally rotate the patient’s hip. Load into socket and articulate through annular range of motion.
(+) Test: Pain
Indicates: Labral or articular cartilage pathology
Apprehension: FABER (1 of 3)
Patient is supine. Patient’s hip is flex, abducted, and externally rotated. Physician induces further external rotation by applying a posterior force on the knee.
(+) Test: Anterior subluxation of hip or apprehension/pain
Indicates: Labral pathology. Can also be positive for impingement.
Rectus Femoris Test
Patient is supine. One hip is flexed up to the chest. The other leg is bent over the edge of the table.
(+) Test: Knee flexion <90°
Indicates: Rectus Femoris contraction
Jump Sign
Patient is seated. Pressure is applied to greater trochanter.
(+) Test: Patient withdraws to “jumps” with pressure
Indicates: Thochanteric Bursitis
Straight Leg Raise Test
Patient is supine. Passively flex the patient’s ipsilateral hip with knee extended.
(+) Test: Pain over lateral leg, especially at >15°.
Indicates: IT Band Contracture. Positive signs usually occur between 30-60° if cause is lumbosacral radiculopathy and/or sciatic neuropathy. Positive signs at >70° is more likely mechanical low back pain due to muscle strain or joint disease.
Piriformis Test
Patient is supine with hip and knee flexed, one ankle crossed over the contralateral knee. Patient abducts against resistance.
(+) Test: Pain over posterior aspect of greater trochanter.
Indicates: Piriformis spasm or pathology.
Patrick’s: FABER (2 of 3)
Patient’s hip is flexed, abducted, and externally
rotated. Physician braces contralateral ASIS, patient
externally rotates/abducts against resistance.
(+) Test: Pain or weakness
Indicates: Gluteus medius pathology
Patrick’s: FABER (3 of 3)
Patient’s hip is flexed, abducted, and externally
rotated. Physician braces contralateral ASIS. Patient internally rotates/adducts against resistance.
(+) Test: anterior or medial groin pain/weakness
Indicates: Iliopsoas insufficiency or pathology
Thomas Test
Patient supine and pulls knees to chest. One leg is
lowered to the table to test the flexibility of the hip
flexors.
(+) Test: Inability to fully extend, or extended leg
raises off table
Indicates: Hip flexor contraction
