Hip Exam - PPT Flashcards
what is the C sign
commonly reported pain distribution pattern for hip joint involvement
why is the hinge a good observation tool? what can be seen?
sagittal plane motion that occurs through many joints
- thoracic spine, lumbar spine motion
- hip, knee, ankle and foot motion
what are some femoral movement faults seen in SLS
trendelenburg / hip adduction
knee valgus / medial rotation
ankle plantarflexion / foot pronation
explain what muscles can be attributed to lower extremity movement faults
posteriolateral hip muscles
general ROM of hip
flexion = 120°
extension = 20°
Abduction = 45°
Adduction = 30°
Internal Rotation = 45°
External Rotation = 45°
femoral anteversion is associated with
IR at the hip that will lead to in-toeing
- will be maxed out in ER, so the only option is for the leg to move internally
femoral retroversion is associated with
ER at the hip that will lead to out-toeing
- will be maxed out in IR, so the only option is for the leg to move externally
hallmark finding associated with femoral anteversion
excessive hip IR
limited hip ER
hallmark finding associated with femoral retroversion
excessive hip ER
limited hip IR
what ROM found at the hip can be indicative of abnormal hip version
difference in hip IR and ER >20°
what makes the boundaries of the femoral triangle
ilioinguinal ligament (superiorly)
adductor longus (medially)
sartorious (laterally)
what is in the femoral triangle
lateral to medial
(NAVEL)
nerve
artery
vein
empty
lymph
what is used to measure hip flexor length
thomas test
how to conduct the thomas test
lying on table supine, have pt raise one leg to 90° hip and knee flexion and support it
lower contralateral leg
abnormal if:
hip cannot reach 0
if loses neutral position
knee drops below 90°
ant pelvic tilt or lumbar spine rotation occurs
how to test piriformis length
pt in supine with hip in 90° flexion
leg is externally rotated
femur adducted
abnormal = pain or loss of ROM
explain the Ober’s test
pt side lying
flex hip and knee to 90°
abduct hip to clear TFL
- move through flexion and extension
move until hip flexes / pelvis tilts
what are the tests for mobility deficits
hip scour
hip quadrant
what are the muscle coordination tests
FABER
FADIR
FAIR
what does SLS test
muscle power/coordination deficit
what may predispose one to gluteal tendinopathies
abnormal hip biomechanics
explain the importance of resisted hip abduction
when paired with greater trochanter palpation test, likelihood to rule in or out greatly increases
if both positive = more likely
if both negative = less likely
if an assessment proves ________, what is indicated?
- pain produced with SLS test
- pain on greater trochanter palpation
Greater Trochanter Pain Syndrome
if an assessment proves ________, what is indicated?
- painful IR and ER
- reduced overall hip ROM
OA of hip
if an assessment proves ________, what is indicated?
- tender lower back
- reduced ROM
- positive SLR
lumbar radiculopathy
performance measures related to arthritic joint pain
6 MWT
30 sec chair stand
TUG
timed SLS
4 square step
step / stair measures
performance measures related to non-arthritic joint pain
Single leg squat test
star excursion balance test
hop distance
single leg sit to stand
what can be done for the population needing higher level performance based measures
single leg:
- hop test
- triple hop test
- crossover triple hop
- 6 M hop for time
what % of contralateral limb is considered “normal”
80-85%
what can a step down test be helpful for
can be a good screen for the hip to point out foot/ankle pathologies
what deviations are observed for during a step-down test
trunk movement
pelvis movement
hip joint movement
knee valgus
heel rising
fall/loss of balance
diagnosis criteria related to SCFE
8-15 years old
males > females
obesity
bilateral cases are common
what is a SCFE
slipped capital femoral epiphysis
slippage of the proximal femoral epiphysis
diagnosis criteria of legg-calve perthes
4-10 years old
males > females
what is a legg-calve-perthes dysplasia
interrupted blood supply to femoral head that results femoral head necrosis
causes comprised bone deformities
