Hip Examination

Question 1

What is the first step?

Answer 1

Introduce self
Patient name and DOB
Explain procedure and gain consent
Ask if in any pain

Question 2

What do you do after the introduction?

Answer 2

Patient stood up
General inspection of the hip ( front , back and side)
Assess gait
Trendelenburg’s test ( place fingers on iliac crest and ask patient to lift one leg at a time, if hip drops on side of lifted leg the left is positive)

Question 3

What do you do after general inspection?

Answer 3

Ask patient to lie down and inspect the hip again lying down

Question 4

What do you do after lying down inspection?

Answer 4

Palpate the joint temperature
Palpate the greater trochanter

Question 5

What do you do after palpation?

Answer 5

Apparent leg length ( umbilicus to medial malleolus)
True leg length ( ASIS to medial malleolus)

Question 6

What do you do after measuring the leg length?

Answer 6

Assess active movements

Flexion ( bring knee up to chest)
Extension ( bring knee back down)

Question 7

What do you do after assessing active movements?

Answer 7

Passive movements

Flexion
Extension
Internal rotation
External rotation
Abduction
Adduction
Extension ( patient lying prone)

Question 8

What do you do after assessing active movements?

Answer 8

Thomas’s Test - place hand on patients lumbar spine and passively flex their hip

Question 9

What do you do to complete the examination?

Answer 9

Present the findings

Neurovascular examination of both lower limbs.
Examination of the lumbar spine and knee joint
Further imaging if indicated (e.g. X-ray and MRI).