Lab- Approach to Hip Complaint Flashcards
What is piriformis exacerbated by?
active external hip rotation
What are the special tests for piriformis syndrome?
log roll and FAIR test
a log roll test that produces posterior pain is indicative of what?
piriformis syndrome with TTP in sciatic notch
a log roll test that produces anterior/groin pain is indicative of what?
intra-articular pathology such as SCFE, FAI, AVN, etc.
a log roll test that produces a clicking sound is indicative of what?
acetabular labral tear
How do you get a positive FAIR test?
if there is pain produced in the sciatic/gluteal area
if a patient presents with pain worse when standing up straight and they are limping, what might they have?
psoas syndrome
how would you test psoas syndrome?
Thomas test, FABER test, and log roll
What are the findings of the specialty tests used for psoas syndrome?
positive thomas test, positive FABER test, negative log roll
what does a positive Thomas test indicate?
hip flexor (psoas) contraction
if a patient presents with pain on the outside of their hip and thigh, and possible buttock pain. Their pain is worse with laying on the affected side, pressing over the greater trochanter, and with activities such as getting out of the car, and going up the stairs. What might they have?
trochanteric bursitis
what specialty tests are used when looking for trochanteric bursitis?
jump sign, ober test, log roll
What are the findings of the specialty tests used for a trochanteric bursitis?
positive jump sign, positive ober, negative log roll
how do you perform the OBER test?
the gluteus medius: the top hip is extended and the knee is flexed at 45-90 degrees. the physician then adducts the hip
how do you get a positive OBER test?
if there is pain at the greater trochanter or if there is an inability to adduct
how might labral tears present?
with locking, clicking, or a catching sensation
How can you test for an intra-articular pathology?
log roll, FABER test, Scour, and labral load/distraction
if you perform a log roll test on a patient you suspect might have an intra articular pathology, what would you be looking for?
pain in the anterior/groin region or clicking
if a patient describes their pain in the hip joint itself, or localize their pain by cupping the anterolateral hip with the thumb and forefinger in the shape of a āCā, what would you suspect?
anterior hip or groin injury
What does a positive FABER test in the groin suggest?
intraarticular disorder or iliopsoas bursitis/ strain
what does a positive FABER test in the buttock region suggest?
sacroiliac joint dysfunction
what does a positive labral loading test indicate?
indicates labral or cartilaginous pathology
what does a positive scour test indicate?
labral or articular cartilage pathology
what does a resisted straight leg raise indicate?
SCFE, femoral acetabular impingement
what is the modified trendelenburg test?
patient stands with feet shoulder width apart and lifts one leg off the ground. A
What is a positive trendelenburg sign?
a drop in the level/height of the iliac crest on the side of the left leg
what does a positive trendelenburg sign indicate?
weakness in hip abductor muscles consisting of gluteus medius and gluteus minimus on PLANTED SIDE
What is the normal ROM of hip flexion with the knee straight?
90 degrees
What is the normal ROM of hip flexion with the knee flexed?
120-135 degrees
What is the normal ROM degree of hip extension?
15-30 degrees
what is the normal ROM degree of internal rotation of the hip?
30-40 degrees
what is the normal ROM degree of external rotation of the hip?
40-60 degrees
what is the normal ROM degree of abduction of the hip with the knee extended?
45-50 degrees
what is the normal ROM degree of adduction of the hip with the knee extended?
20-30 degrees
What does C sign indicate?
intra-articular pathology
What might a positive OBER test indicate?
IT band contracture
how do you get a positive OBER test?
inability to adduct
