Hip Special Tests Flashcards
Patrick’s (FABER) Test
PURPOSE- Identify hip dysfunction, such as mobility restriction
DESCRIPTION- Patient lies supine. (Passively) flex, abduct and externally rotate hip test leg so that the foot of the test leg is on top of the knee of the opposite leg. Slowly lowers the knee of the test leg toward the examining table.
RESULT- A negative test is indicated by the test leg’s knee falling to the table or at least being parallel with the opposite leg.
A positive test is indicated by the test leg’s knee
remaining above the opposite straight leg. Positive
the test indicates that the hip joint may be affected,
that there may be iliopsoas spasm, or that the sacroiliac joint may be affected.
Grind/Scour Test
PURPOSE- Identify DJD of hip joint
DESCRIPTION- The patient lies supine. The examiner flexes and adducts the patient’s hip so that the hip faces the patient’s opposite shoulder and resistance to the movement is felt
RESULT- May reproduce pain in hip joint and refer pain to knee or elsewhere
Trendelenburg Sign
PURPOSE- To identify weakness of gluteus medius or unstable hip joint.
DESCRIPTION- The patient is asked to stand on one lower limb. Normally, the pelvis on the opposite side should rise; this finding indicates a negative test
RESULT- If the pelvis on the opposite side (non-stance side) drops when the patient stands on the affected leg, a positive test is indicated.
Thomas Test
PURPOSE- Identifies tightness of hip flexors (Iliopsoas primarily)
DESCRIPTION- The patient lies supine while the examiner checks for excessive lordosis, which is usually present with tight hip flexors. The examiner flexes one of the patient’s hips, bringing the knee to the chest to flatten out the lumbar spine and to stabilize the pelvis. The patient holds the flexed hip against the chest.
RESULT- If there is no flexion contracture, the
hip being tested (the straight leg) remains on the examining table.
If a contracture is present, the patient’s straight leg raises off the table and a muscle stretch end feel will be felt
Ober’s Test
PURPOSE- To identify tightness of TFL/IT band
DESCRIPTION- The patient is in the side lying position with the lower leg flexed at the hip and knee for stability. The examiner then passively abducts and extends the patient’s upper leg with the knee straight or flexed to 90°. The examiner slowly lowers the upper limb
RESULT- If a contracture is present, the leg remains abducted and does not fall to the table.
Ely’s Test
PURPOSE- To identify tightness of rectus femoris.
DESCRIPTION- The patient lies prone, and the examiner passively flexes the patient’s knee
RESULT- On flexion of the knee, the patient’s hip on the same side spontaneously flexes, indicating that the rectus femoris muscle is tight on that side and that the test is positive.
90-90 Hamstring Test
PURPOSE- Identify hamstring tightness
DESCRIPTION- The supine patient flexes both hips to 90° while the knees are bent. The patient may grasp behind the knees with both hands to stabilize the hips at 90° of flexion. The patient actively extends each knee in turn as much as possible.
RESULT- Positive if knee is unable to reach 10 degree from neutral position (lacking 10 degree of extension)
Tripod Sign
PURPOSE- Identifies tightness of hamstring muscle.
DESCRIPTION- The patient is seated with both knees flexed to 90° over the edge of the examining table. The examiner then (passively) extends one knee.
[If the hamstring muscles on that side are tight, the patient extends the trunk to relieve the tension in the hamstring muscles. The leg is returned to its starting position, and the other leg is tested and compared with the first side. Extension of the spine is indicative of a positive test]
RESULT- Extension of the spine is indicative of a positive test.
Piriformis Test
PURPOSE- Identifies piriformis syndrome
DESCRIPTION- The patient is in the side lying position with the test leg uppermost. The patient flexes the test hip to 60° with the knee flexed. The examiner stabilizes the hip with one hand and applies a downward pressure to the knee
RESULT- If the piriformis muscle is tight, pain is elicited in the muscle. If the piriformis muscle is pinching the sciatic nerve, pain results in the buttock and sciatica may be experienced by the patient
Leg Length Test
PURPOSE- Identifies true leg length discrepancy
DESCRIPTION- True leg length is measured by placing the patient in a supine position with the ASISs level and the patient’s lower limbs perpendicular to the line joining the ASISs. Using a flexible tape measure, the examiner obtains the distance from the ASIS to the medial or lateral malleolus on the same side. The measurement is repeated on the other side, and the results are compared.
RESULT - A difference of 1 to 1.3 cm (0.5 to 1 inch) is considered normal.
Craig’s Test
PURPOSE- It is used to identify abnormal femoral anteversion
DESCRIPTION- The patient lies prone with the knee flexed to 90°. The examiner palpates the posterior aspect of the (greater trochanter) of the femur. The hip is then passively rotated medially and laterally until the greater trochanter is parallel with the examining table or reaches its [most lateral position]
RESULT- The degree of anteversion can then be estimated, based on the angle of the lower leg with the vertical. (Normal Anteversion 8-15 degrees)
