Hip examination Flashcards
What do you look for when inspecting from the front?
Scars
Pelvic tilt
Quadriceps wasting
What can cause lateral pelvic tilt? (3)
scoliosis
leg length discrepancy
hip ABductor weakness
What do you look for when inspecting from the side?
Lumbar lordosis
Knee flexion
Foot arches
What do you look for when inspecting from behind?
Scars
Muscle wasting
What do you look for on gait?
- Gait cycle
- Limping
- Turning
What are the 5 stages of the gait cycle?
- Heel strike
- Foot flat
- Mid-distance
- Heel-off
- Toe-off
(also check arm swing)
What is the difference between a trendelenburg’s and waddling gait?
Trendelenburg’s gait = unilateral hip ABductor weakness
Waddling gait = bilateral hip ABductr weakness
If a patient has pain over the greater trochanter what does this suggest?
Trochanteric bursitis
How do you measure apparent leg length?
Umbilicus to tip of medial malleolus
Xiphisternum to tip of medial malleolus
How do you measure true leg length?
ASIS to tip of the medial malleolus
What do you say to the patient to check active hip flexion?
Bring your knee as close to your chest as possible
What is the normal ROM of active hip flexion?
120 degrees
What do you say to the patient to check active hip extension?
Straighten your leg out so that it is flat on the bed
What is the normal ROM of active hip extension?
180 degrees
What is the normal ROM in PASSIVE hip flexion?
120 degrees
What is the normal ROM in PASSIVE hip internal rotation?
40 degrees
What is the normal ROM in PASSIVE hip external rotation?
45 degrees
What is the normal ROM of PASSIVE hip ABduction?
45 degrees
What is the normal ROM of PASSIVE hip ADduction?
30 degrees
What is the normal ROM of PASSIVE hip extension?
10-20 degrees
What are the special tests in hip exam?
Thomas’s test
Trendelenburg’s test
What does Thomas’s test assess for?
Fixed flexion deformity
In which patients should Thomas’s test not be performed on and why?
Those with hip replacement as it can cause dislocation
What does Trendelenburg’s test assess for?
Hip abductor weakness (gluteus medius and minimus)
What further assessments do you do to complete a hip exam?
- Neurovascular examination of both lower limbs
- Examination of the joints above (lumbar spine)
- Examination of the joint below (knee joint)
- Further imaging if indicated (X-ray and MRI)
