Hip examination

Question 1

what is the structure of a hip exam?

Answer 1

stand the patient
walk the patient
trendelenberg's test
lie the patient down
square the hips
thomas' test
range of motion 
special tests

Question 2

what are we looking for when we stand the patient?

Answer 2

look for scars swelling or deformities

Question 3

what are we looking for when we walk the pateint?

Answer 3

check for abnormal gait, limp, if they need a walking stick etc. DO NOT WALK THEM FOR TOO LONG, JUST BACK AND FORWARD ONCE

Question 4

what is trendelenberg’s test looking at?

Answer 4

examines the abductor function

Question 5

how is trendelenberg’s test carried out?

Answer 5

Ask patient to lift leg but BEHIND them, DO NOT recruit hip flexors, non-function abduction of standing leg causes the opposite side to drop (sound side sags)

Question 6

why do we square the pelvis?

Answer 6

to look for any asymmetry in the leg length/ hips

Question 7

what is thomas’ test checking for?

Answer 7

fixed hip flexion

Question 8

how is thomas’ test carried out?

Answer 8

Eliminate lumbar lordosis (patient hold one leg up), look for fixed flexion of the other hip by asking to straighten the other leg (measure angle if leg is unable to straighten), unable to get affected hip / leg to the bed when they have a straight spine

Question 9

how do we test the hips range of motion?

Answer 9

Flexion, internal and external rotation (angles), abduction, adduction (hand on pelvis and move leg out and in) - look at face note discomfort, ask about pain

Question 10

what special tests might you have to do for a hip exam?

Answer 10

neurovascular tests - ask if they can feel you touching their toes, pulses, reflexes