Hip Exam

Question 1

Hip Anatomy

Answer 1

Iliac Crest
Anterior Superior Iliac Spine (ASIS)
Greater Trochanter
Pubic Tubercle
Posterior Superior Iliac Spines (PSIS)
Ischial Tuberosity

Question 2

Hip Flexion (Knee Straight)

Answer 2

Illiopsoas, sartorius, rectus femoris, tensor fascia latae ms.

90°

Question 3

Hip Flexion (Knee flexed)

Answer 3

Illiopsoas, sartorius, rectus femoris, tensor fascia latae ms.

120-135°

Question 4

Hip Extension

Answer 4

Gluteus maximus m. and Hamstring ms.

15-30°

Question 5

Hip Internal rotation

Answer 5

30-40°

Question 6

Hip External Rotation

Answer 6

Sartorius, gluteus medius, gluteus maximus ms.

40-60°

Question 7

Hip abduction with knee extended

Answer 7

Gluteus medius and minimus ms. Also gluteus maximus, sartorius, and tensor fascia latae.

45-50°

Question 8

Hip adduction with knee extended

Answer 8

Adductor longus m.

20-30°

Question 9

Patellar Tendon Reflex Nerve Root

Answer 9

L4

Question 10

Achilles Tendon Reflex Nerve Root

Answer 10

S1

Question 11

Palpable Pulses for LE

Answer 11

femoral, popliteal, posterior tibial, dorsalis pedis as.

Question 12

Central Hip Compartment

Answer 12

Labrum, ligamentum teres, articular surfaces.

Question 13

Peripheral Hip Compartment

Answer 13

Femoral neck, synovial lining

Question 14

Lateral Hip Compartment

Answer 14

Gluteus medius, gluteus minimus, piriformis, IT band, trochanteric bursae

Question 15

Anterior Hip Compartment

Answer 15

Illiopsoas insertion, illiopsoas bursae.

Question 16

Log Roll

Answer 16

Roll the patient’s leg into internal and external rotation.

(+) Test: Pain

Indicates: Central or peripheral compartment pathology

Question 17

C-Sign

Answer 17

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

Question 18

Labral Loading

Answer 18

Flex the patient’s knee and hip to 90°, load into the femur towards the innominate

(+) Test: pain

Indicates: Labral or cartilaginous pathology

Question 19

Labral Distraction

Answer 19

Distract patient’s femur away from innominate

(+) Test: Improvement of pain.

Indicates: Labral or cartilaginous pathology

Question 20

Scour

Answer 20

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

Question 21

Apprehension: FABER (1 of 3)

Answer 21

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.

Question 22

Rectus Femoris Test

Answer 22

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

Question 23

Jump Sign

Answer 23

Patient is seated. Pressure is applied to greater trochanter.

(+) Test: Patient withdraws to “jumps” with pressure

Indicates: Thochanteric Bursitis

Question 24

Straight Leg Raise Test

Answer 24

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.

Question 25

Piriformis Test

Answer 25

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.

Question 26

Patrick’s: FABER (2 of 3)

Answer 26

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

Question 27

Patrick’s: FABER (3 of 3)

Answer 27

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

Question 28

Thomas Test

Answer 28

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