Hip examination Flashcards
What are the introductory steps for a hip examination?
- Wash hands.
- PPE.
- Introduce self.
- Patient name and DOB.
- Explain the examination.
- Gain consent.
- Offer a chaperone.
EXTRA STEPS:
- Take off patient’s trousers, socks and shoes.
- Ask about pain in the legs/back.
What comes after introduction for a hip examination?
Inspection (LOOK).
How is inspection carried out?
Ask the patient to stand up:
- Inspect the patient from the front, laterally and from the back.
- Assess gait.
Ask the patient to lie on the couch:
- Inspect the groin and thigh regions for scars/muscle bulk abnormalities.
- If possible, roll patient onto their side to assess the gluteal regions.
Assess leg length:
- Apparent leg length = xiphisternum to medial malleolus of each leg.
- True leg length = ASIS to medial malleolus of each leg.
What comes after inspection?
- Palpation (FEEL).
How is palpation carried out?
Again ask the patient if they have any pain or tenderness in their hips.
- Check temperature in the upper thigh/lateral thigh.
- Assess the greater trochanter (mediolaterally on the arse).
What comes after palpation of the hip joint?
- Active MOVE assessment.
How is the active movement of the hip assessed?
- Flexion (bring your knee as close to your chest as you can).
- Extension (lie with your leg flat on the bed).
- Abduction (swing your leg out to the side).
- Adduction (cross your leg onto the other side).
What comes after active MOVE assessment?
- Passive MOVE assessment.
How is the passive movement of the hip assessed?
- Assess flexion, extension, abduction and adduction passively.
- ALSO ASSESS INTERNAL AND EXTERNAL ROTATION PASSIVELY.
What comes after passive movement assessment?
Special tests.
What are the special tests used to assess hip function?
Thomas’s test:
- Place hand on lumbar spine.
- Flex the UNAFFECTED hip joint.
- Observe for the AFFECTED thigh raising off the bed.
- Suggests a loss of extension in the affected hip.
Trendelenburg’s test:
- Ask patient to stand on one leg.
- Observe for a dip of the pelvis on the contralateral side (pathological).
What comes after special tests in assessment of the hip?
Conclusion.
How is the hip examination concluded?
Would like to:
- Examine the lumbar spine and ipsilateral knee joint.
- Perform a neurological and vascular examination of the lower limb.
- Thank the patient.
- Request they redress.
- Wash your hands.
How is the hip examination concluded?
Would like to:
- Examine the lumbar spine and ipsilateral knee joint.
- Perform a neurological and vascular examination of the lower limb.
- Thank the patient.
- Request they redress.
- Wash your hands.
How is the hip examination concluded?
Would like to:
- Examine the lumbar spine and ipsilateral knee joint.
- Perform a neurological and vascular examination of the lower limb.
- Thank the patient.
- Request they redress.
- Wash your hands.
