Hip Examination

Question 1

Look:

What should the patient wear?

With the patient standing, what do you look for? - 3

Answer 1

Underwear only

Shoulder symmetry
Pelvic tilt
Gluteal wasting

Question 2

Feel:

What do you feel for over the greater trochanter?

Answer 2

Trochanteric bursitis

Question 3

Move:

Passive:
- Flexion at 90 degrees and watch face for pain!

Thomas test:

• What do you do?
• What does it show?

You can also test for I and E rotation. Which type of usually the first to be impaired in OA?

Answer 3

Put left-hand palm upwards under lumbar spine so the patient can’t cheat

Fully flex one hip

If the other leg moves of the couch, there is a fixed flexion deformity due to capsular fibrosis and osteophytes in OA.

Internal rotation

Question 4

Special test - Trendelenberg test:

What do you ask the patient to do?

What is a positive test?

What muscles are weak resulting in this?

What phrase is commonly used to remember this?

Answer 4

Stand in front

Place hands on ASIS (optional)

Stand on one leg for 30 seconds

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The pelvis falls on the side of the lifted leg

Hip abductors - there are other causes

Sound side sags

Question 5

Special test - Gait:

What is an antalgic gait? - seen in OA

What does a Trendelenberg gait look like?

Answer 5

Short stance on the affected side

A waddle, hence a waddling gait