Hip joint exam

Question 1

What is the correct order of items you need to do on a joint exam?

Answer 1

Inspection, palpation, range of motion, neurovascular exam, specialty tests

Question 2

Do you perform all examinations bilaterally?

Answer 2

YES

Question 3

What are you looking for upon inspection?

Answer 3

Asymmetry, swelling, bruising, general appearance, gait

Question 4

What are you palpating and looking for?

Answer 4

Greater trochanter, ASIS, iliac crests

Looking for tenderness, tissue texture abnormalities, temperature

Question 5

What are the range of motions at the hip?

Answer 5

Flexion, extension, abduction, adduction, internal and external rotation

Question 6

The strength test values

Answer 6

Assessed 0/5 - 5/5

5/5 = normal, 0/5 = no contraction

Question 7

What is the normal value for a strength test?

Answer 7

5/5 - full active motion against resistance from me with no fatigue

Question 8

What is included in the neurovascular exam?

Answer 8

Reflexes, sensation, pulses, capillary refill

Question 9

What are the specialty tests for the hip joint?

Answer 9

Log roll, FAIR, thomas test, FABER, jump sign, Ober test, Labral loading and distraction, Scour test, straight leg raise

Question 10

How would you perform a log roll?

Answer 10

Patient supine, internally and externally rotate their thigh

+ test = pain or clicking

Question 11

How would you perform a FAIR test?

Answer 11

Patient lateral recumbent - Flexion, Adduction, internal rotate of hip
+ test = pain in sciatic/gluteal region

Question 12

What is a FAIR test testing?

Answer 12

Piriformis syndrome (sciatic impingement)

Question 13

How would you perform a Thomas test?

Answer 13

Patient supine with legs hanging off of the table, have them flex one knee to their chest and if their extended leg is unable to fully extend or comes off of the table = + test

Question 14

What is a Thomas test testing?

Answer 14

Hip flexors - iliopsoas

Question 15

How would you perform a FABER test?

Answer 15

Flexion, ABduction, external rotation with patient supine - have knee crossed onto other leg and push down
+ test = pain

Question 16

How would you perform a jump sign and what is it testing?

Answer 16

Press against the greater trochanter when patient is sitting and if there is pain, they may have trochanteric bursitis

Question 17

How would you perform the Ober test?

Answer 17

Patient lateral recumbent, top hip extended, knee flexed and Adduct it
+ test = pain or inability to adduct

Question 18

How would you perform a labral loading/distraction test?

Answer 18

Patient supine, flex hip and flex knee and load into it or pull away

Question 19

How would you perform a Scour test?

Answer 19

Patient supine, flex and externally rotate hip and load in to it

Question 20

What are labral loading/distraction and the Scour test testing?

Answer 20

Labral tears and cartilagenous injuries

Question 21

How would you perform a straight leg raise test?

Answer 21

Patient supine, flex their hip (raise leg) and keep knee extended
+ test = if they resist or feel pain

Question 22

What is a normal ROM for hip flexion?

Answer 22

90

Question 23

What is a normal ROM for hip extension?

Answer 23

15-30

Question 24

What is a normal ROM for hip abduction?

Answer 24

45-50

Question 25

What is a normal ROM for hip adduction?

Answer 25

20-30

Question 26

What is a normal ROM for hip internal/external rotation?

Answer 26

30-40

Question 27

What is the patellar reflex testing?

Answer 27

L4

Question 28

What is the achilles reflex testing?

Answer 28

S1

Question 29

What is the scale for reflex testing?

Answer 29

0/4 - 4/4 0/4 = absent reflex +2/4 = normal +4/4 = Hyperactive and not normal

Question 30

How would you do a dermatome/sensory test?

Answer 30

Have patients close eyes, ask if they can feel this bilaterally, on knee cap, down leg and on to medial and lateral foot sides

Question 31

Where would you check for pulses?

Answer 31

Posterior tibialis - behind medial mallelous | Dorsalis pedis - on dorsal foot

Question 32

What is the scale for pulses?

Answer 32

0/3 - 3/3 +2/3 = normal +3/3 = bounding

Question 33

What tests would be positive on someone with piriformis syndrome?

Answer 33

``` Log roll (external rotation) and FAIR test Pain in gluteal region ```

Question 34

With a log roll, pain in the groin or anterior side could possibly mean what?

Answer 34

FAI, AVN, SCFE or clicking = labral tear | Intra-articular pathologies

Question 35

To test if piriformis syndrome is causing sciatic nerve irritation, what test you would perform?

Answer 35

FAIR - lateral recumbant, flex top hip and knee, adduct and internally rotate

Question 36

Positive findings for the FABER test with pain in groin could mean what?

Answer 36

Intra-articular things like FAI, Labral tear or osteoarthritis

Question 37

Positive findings for the FABER test with pain in the buttock region could mean what?

Answer 37

Sacroilitis

Question 38

Describe the OBER test

Answer 38

Pt lateral recumbant, top hip extended, knee flexed and adducted

Question 39

What can a positive ober test mean?

Answer 39

Trochanteric bursitis

Question 40

What does performing the log roll with a negative finding rule out?

Answer 40

Intra-articular things

Question 41

If the labral load and scour tests were positive for pain and the labral distraction was positive for IMPROVEMENT of pain what could that suggest?

Answer 41

Cartilagenous involvement

Question 42

Pain with a SLR between 30-60 degrees indicates what?

Answer 42

Lumbar disc herniation between L4-S1