Hip Exam Competency Flashcards
What structures are found in the central compartment of the hip?
Labrum Ligamentum teres Articular surfaces
What structures are found in the peripheral compartment of the hip?
Femoral neck Synovial lining
What structures are found in the lateral compartment of the hip?
Gluteus medius Gluteus minimus Iliotibial band Trochanteric bursae (deep and superficial))
What structures are found in the Psoas compartment of the hip?
Iliopsoas insertion and bursae
What are the 5 tests that can be done to test the central compartment of the hip?
Log roll (can be for peripheral compartment too) Labral loading Labral distraction Scour Apprehension: FABER
WHat does a C-sign tell you?
Pathognomic of labral pathology
What types of pain would indicate an issue iin the central compartment of the hip?
Lumbar spine pain Groin/medial pain Pelvic rim pain (anterior to posterior, (L5-S1) radicular pain) Pain in the mornning or after a run
What are 4 signs and symptoms of an issue with the central compartment of the hip?
C-sign Catching, locking Pain Instability
What types of things could cause an injury to the central compartment of the hip?
Trauma (traffic accidents, collisions, bad falls) Twisting on a hip that has excess weight on it Repetitive strain (golfers)
Labral tears, ligamentum teres disruption, osteochondral defects, chondromalacia/osteoarthritis, and loose bodies are all pathologies found in what compartment of the hip?
Central
What is indicative of a positive log roll test?
Pain - this is testing the central compartment of the hip
What is indicative of a positive labral loading test?
Pain - This is testing the central compartment of the hipp
What is indicative of a positive labral distraction test?
Relief of pain - This is testing the central compartment of the hip
What is indicative of a positive scour test?
Pain - This is testing the central compartment of the hip
What is indicative of a positive Apprehension: FABER test?
Pain or apprehension - This is testing the central compartment of the hip
How do you perform a log roll test?
Roll pts leg into internal and external rotation
How do you perform a labral loading test?
Flex pts knee and hip to 90, load into the femur towards the innominante
What does a positive labral loading test tell you?
Labral or cartilaginous pathology
How do you perform a labral distraction test?
Distract pts femur away from innominate
What does a positive labral distraction test tell you?
Labral or cartilaginous pathology
How do you perform a scour test?
Flex and externally rotate pts hip. Load into socket and articulate through annular ROM
What does a positive scour test tell you?
Labral or articular cartilage pathology
How do you perform a apprehension: FABER test?
Pts hip flexed, abducted and externally rotated. Dr induces further external rotation by applying a posterior force to the knee
What does a positive apprehension: FABER test tell you?
Labral pathology
What 2 tests can you perform to test the peripheral compartment of the hip?
Ely’s test Rectus femoris test
How do you perform an Ely’s test?
Pt prone, passively flex pts knees
What is indicative of a positive elys test?
Ipsilateral hip raises off table
What does a positive elys test tell you?
Rectus femoris contracture
How do you perform a rectus femoris test?
Pt supice, one hip flexed up to the chest and the other leg bent over the table
What is indicative of a positive rectus femoris test?
Knee flexion <90
What does a positive rectus femoris test tell you?
Rectus femoris contraction ipsilaterally
What 6 tests can you use to test the lateral compartment of the hip?
Jump sign Straight leg raise test Ober’s test Piriformis test Trendelenburg Patrick’s: FABER
How do you perform a jump sign test?
Pt is seated, pressure is applied to greater trochanter
What does a positive jump sign test tell you?
Trochanteric bursitis
How do you perform a straight leg raise test?
Raise the leg with knee extended, nonspecific test
What does a positive straight leg raise test tell you?
Pain from 15-30 degrees = lumbar disc etiology Pain laterally >15 degrees = lateral compartment pathology
How do you perform an Ober’s test?
Pt lateral recumbent with doctor standing behind the pt. Dr abducts the top leg and then lowers leg to the table while stabilizing hip
What is indicative of a positive Ober’s test?
Inability to adduct
What does a positive ober’s test tell you?
IT band contracture
How do you perform a piriformis test?
Pt supine with hip and knee flexed, one ankle crossed over contralateral knee. Pt abducts against resistance
What is indicative of a positive piriformis test?
Pain over posterior aspect of greater trochanter
What does a positive piriformis test tell you?
Piriformis spasm or pathology
How do you perform a trendelenburg test?
Pt standing with dr behind. Pt lifts one foot off ground
What is indicative of a positive trendelenburg test?
Weakness/inability to hold hips level
What does a positive trendelenburg test tell you?
Contralateral gluteus medius weakness (ssuperior gluteal nerve) - Ex. Pt lifts right foot, right hip drops = left gluteus medius/superior gluteal nerve pathology
How do you perform a Patrick’s: FABER test for the lateral compartment of the hip?
Pts hip is flexed, abducted and externally rotated. Dr braces contralateral ASIS, pt externally rotates/abductts against resistance
What is indicative of a positive Patrick’s: FABER test for the lateral compartment of the hip?
Pain or weakness
What does a positive Patrick’s: FABER for the lateral hip compartment tell you test tell you?
GLuteus medius pathology
What 3 tests can you do to test the anterior/iliopsoas compartment of the hip?
Patrick’s: FABER Psoas test Thomas test
How do you perform a Patrick’s: FABER for the anterior/iliopsoas compartment of the hip?
Pts hip is flexed, abducted and externally rotated. Dr braces contralateral ASIS. Pt internally rotates/adducts against resistance
What is indicative of positive patrick’s: FABER for the anterior/iliopsoas compartment of the hip?
Anterior or medial groin pain/weakness
What does a positive patrick’s: FABER test for the anterior/iliopsoas compartment tell you?
Iliopsoas insufficiency or pathology
How do you perform a psoas test?
Flex hip to 30 degrees while pt further flexes against resistance
What is indicative of a positive psoas test?
Pain/inability or snapping
What does a positive psoas test tell you?
Psoas contracture or pathology
What are signs and symptoms of an injury to the peripheral compartment of the hip?
Catching/locking Pain with hip movement (deep hip and goin) Limited ROM
What causes injury to the peripheral compartment of the hip?
Congenital Post trauma (Fall, MVA)
Difficulty with lifting leg to climb stairs would indicate an injury to what compartment of the hip?
Lateral compartment
Where would pain be in a pt that has an injury to the lateral compartment of the hip?
Lateral hip Pelvic rim Radiating down leg to knee Knee pain (seen a lot in pts with problem with IT band)
What are common causes of injury to the lateral compartment of the hip?
Lifting Trauma Overuse
What are common ways to injur the anterior/iliopsoas compartment of the hip?
Hyperextension (jumping and running) Overuse
Where would pain be in a pt with an injury to the anterior/iliposoas compartment of the hip?
Anterior hip Medial groin Anterior deepp thigh
A snapping hip can be a compensatory condition of a pt wiht injury to the anterior/iliopsoas compartment of the hip. What is the difference between internal and external snapping?
Internal = psoas snaps over femoral head External = IT band snaps over trochanter
What hip pathology is shown in the image?
Fracture of left pubic rami
What hip pathology is shown in the image?
Posterior hip dislocation
What hip pathology is shown in the image?
Subcapital femoral fracture
What hip pathology is shown in the image?
Arthritis in left hip
