Hip Examination Flashcards
Observation
Standing - spinal alignment, iliac crest level, PSIS and ASIS level, gluteal bulk, gluteal folds, knee creases, pelvic tilt, knee hyperextension, quadriceps bulk, alignment of femur and tibia, foot posture
Supine - resting position of leg
Watch how they take off shoes and socks
Leg length measurement
Bony or functional
Direct - measure ASIS to tip of lateral malleolus or from ASIS to lateral tibial condyle for femoral length then from lateral tibial condyle to lateral malleolus for tibial length, take mean of 2-3 measurements
Indirect - height of iliac crest/ASIS in standing
Functional tests
Sitting
Sit to stand
Walking - weight bearing, limp, external or internal rotation of hip
Lye to sit and sit to lye - abduction of hip
Steps
Single leg stand - palpate PSIS, positive test if pelvis drops on non-weight bearing side
Squat, mini dip, hop, jog
Palpation
Greater trochanter
Pubic symphysis
Ischial tuberosity
ASIS, PSIS, iliac crest level
Joint line - inguinal ligament, hernia, femoral pulse
Temperature
Active range of motion
Supine;
Flexion - knee to chest
Abduction - stabilise pelvis
Adduction - stabilise pelvis, one knee bent over other
Medial and lateral rotation
Prone or side lying;
Extension - stabilise pelvis, no bending in spine
Internal and external rotation in children
Passive range of motion
Supine;
Flexion - knee to chest
Abduction - stabilise pelvis
Adduction - stabilise pelvis, one knee bent over other
Medial and lateral rotation
Prone or side lying;
Extension - stabilise pelvis, no bending in spine
Internal and external rotation in children
Isometric
Hip flexors
Hip extensors
Hip abductors
Hip adductors
Hip medial and lateral rotators
Muscle length tests
Thomas test - hip flexors, edge of bed, hold knee and roll back, should be flush
Hamstring - popliteal angle, 90 at hip and knee, straighten the knee
Quadriceps - heel to buttock in prone
FABER
Patient lays supine
Flex, abduct and externally rotate the leg
FADDIR
Patient lays supine
Flex, adduct and internally rotate the leg
OBERS
Patient lays on their side
Flex the knee and abduct the leg (up) gently lower the leg until rests on the plinth or will not go any further
Stabilise the pelvis
Quadrant test
Patient lay supine
Flex the knee to bum
Place both hands on the knee and apply a downwards pressure to the hip joint
Rotate the leg from side to side in circles
