Hip examination

Question 1

look

Answer 1

Patient standing
Quadriceps, hamstring, gluteal muscle mass

Gait
Pace, symmetry, gross gait abnormalities, walking aids Note an antalgic, stiff, or Trendelenburg gait.

Patient lying on couch
Local inspection of hip for erythema or skin changes, swelling over greater trochanter, bruising, scars, attitude of limb

Question 2

feel

Answer 2

one side only

Greater trochanter
Groin (mid-point and medially)

Question 3

move

Answer 3

Flexion100-130o (passive and active)
Internal rotation 15o (passive only)
External rotation 40o (passive only)
Adduction15o (passive only)
Abduction45o (passive only)

Question 4

tests

Answer 4

limb lengths
trendelenburg

Question 5

how do you measure true limb lengths

Answer 5

True limb length: with the patient supine measure from the ASIS to the tip of the medial malleolus. True shortening may be seen in fractures, missed congenital hip discoloration, perthes or slipped upper femoral epiphysis.

Question 6

how do you measure apparent limb length

Answer 6

Apparent limb length: with the patient supine measure from the xiphisternum to the medial malleolus. Apparent shortening may occur with a spinal scoliosis or a fixed flexion deformity of the hip.

Question 7

what does trendelenburg’s test

Answer 7

abductor power