Hip examination Flashcards
What to think with clicking, catching of hip: pain increased by full flexion or extension
Acetabular labral tears
What to think with constant low back/buttock pain with same side groin pain
Hip OA
What to think with Lateral thigh pain: increasing when moving from sit to stand
Greater trochanteric bursitis, Muscle strain
What to think with Age >60, pain and stiffness in hip with possible radiation to groin
Hip OA
What to think with deep aching throb to hip or groin: possible history of prolonged steroid use
Avascular necrosis
What to think with Sharp pain in groin
Femoroacetabular (anterior) impingement
What to think with pain in the gluteal region with occasional radiation into posterior thigh and calf
Piriformis syndrome, hamstring strain, ischial bursitis
What is Baer’s line
between ASIS and umbillicus
How would you palpate Iliopsoas
Supine, Contralateral leg is help up by pt. Leg you are palpating is extended.
Then using Baer’s line (ASIS and Umbillicus) move 1/3 away from umbillicus and press into abdominal soft tissue
Closed Packed Position for hip
Max Ex, IR, slight abduction
Open packed position for the hip
30 Flexion, 30 ABduction, Slight ER
Capsular pattern for the hip
Flex=ABduction=IR, slight loss of ex, little to no loss ER
Trendelenburg Test
For Lateral Hip tendon pathology
Standing pt raises one leg 10cm and holds 30 sec Is a (+) test if: pelvis drops on the raised leg or trunk shifts to stance leg >1 inch
Trochanteric Bursitis Test
For trochanteric bursa inflamm or irritation
Pt is S/L with affected side up, stabilize pelvis and then
extend hip and flex knee -> moving into adduction and then flexion
(+) is reproduction of symptoms
Ober Test
For TFL/ITB tightness
pt is S/L with examined leg up
Stabilize pelvis and flex knee to 90 degrees and aBduct and extend hip until hip is in line with trunk
Allow gravity to adduct hip as much as possible without medial rotation
(+) unable to adduct towards table
minimal tightness= leg past horizontal but not to table
moderate tightness= leg to horizontal
max tightness= not to horizontal
Thomas Test
For tightness of Psoas, TFL/ITB, Rectus
pt is supine at end of table. Make sure pt back is flattened. Then bring one leg towards chest- Make sure not to go all the way to chest this will create a posterior pelvic tilt.
Then begin test of examined leg- this is a passive test
Feeling for rotation of the ASIS the entire time
- bent knee leg drop- the leg should hit the table (neutral) - if not than psoas may be tight
- more range in ABduction than neutral= tight TFL
- when lowering leg if the knee kicks out= rectus tightness
S/L Abduction
For assessing muscle imbalances
1. Have pt s/l and Abduct hip- observing the movement pattern. If pt goes into hip flexion or IR think- dominance in TFL
or
- Place leg into abduction, extension and ER. have them then actively hold the position
If leg IR or flexes- then think dominance in TFL
Straight Leg Raise
For assessing muscle imbalances and movement impairments- and pelvic instability
Pt is supine, palpate greater trochanter and have pt actively perform SLR. The axis of motion should not change much under you finger
(+) if axis moves anterior >1/2 inch- think muscle imbalances around the hip or posterior capsular tightness
Patrick’s FABER test
For OA
Pt is supine. then leg is flexed, aBducted and ER.
The lateral ankle is positioned just proximal to opp knee.
Then ASIS on contra side is stabilized and involved leg is lowered and overpressure is added
(+)
reproduction of pain
anterior pain- implies soft tissue shortening or articular pathology
posterior pain- implies SIJ pathology
FAIR or FADIR
For impingement test
Pt is supine and leg is flexed, adducted and IR
go into end range and can apply overpressure into IR
(+)
pain in groin or buttock region
Scour
For OA
pt supine and hip moves from extension, abduction andER and goes into flexion, adduction and IR
Axially load is applied
(+)
reproduction of symptoms
Craig’s Test
For ant/retroversion
Pt is prone and knee flexed to 90 degrees
Palpate greater trochanter- finding the most lateral position
Then measure from knee up the shaft of tibia
Normal = 8-15 degrees
Less= retroversion more= anteversion
Normal range for ant/retroversion of Hip
8-15 degrees
Patellar- Pubic - Percussion
For detecting hip fractures
Supine. Tapping on one patella at a time while auscultating the pubic symphysis
(+)
diminution of sound on affected side
