Orthopedic Diagnosis: Hip & Pelvis

Question 1

Leg Length Discrepancy

Answer 1

• Positive: Different measurements
  
  1. Indicates: True - Bony abnormality above or below the level of trochanter difference (anatomical short leg)
  2. Indicates: Apparent - Pelvic obliquity (tilted pelvis)

Question 2

Allis Sign

Answer 2

1. Positive: Difference in height, if one knee is lower
   
   • Indicates: Ipsilateral congenital hip dislocation or tibial discrepancy (anatomical short leg)
2. Positive: Difference in anteriority, if one knee is anterior
   
   • Indicates: Ipsilateral congenital hip dislocation or femoral discrepancy (contralateral anatomical short leg)

Question 3

Galeazzi Sign

Answer 3

1. Positive: Difference in height, if one knee is lower
   
   • Indicates: Ipsilateral congenital hip dislocation or tibial discrepancy (anatomical short leg)
2. Positive: Difference in anteriority, if one knee is anterior
   
   • Indicates: Ipsilateral congenital hip dislocation or femoral discrepancy (contralateral anatomical short leg)

Question 4

Thomas Test

Answer 4

• Positive: Lumbar spine maintains lordosis (should flatten) and hip or leg flexes
  
  • Indicates: Contracture of the hip flexors (iliopsoas)

Question 5

Anvil Test

Answer 5

• Positive: Localized pain in long bone or in hip joint
  
  • Indicates: Possible fracture of long bones, or hip joint pathology

Question 6

Patrick Test

Answer 6

• Positive: Pain in the hip region
  
  • Indicates: Hip joint pathology

Question 7

FABERE Sign

Answer 7

• Positive: Pain in the hip region
  
  • Indicates: Hip joint pathology

Question 8

Laguerre Test

Answer 8

1. Positive: Pain in the hip joint
   
   1. Indicates: Hip joint pathology
2. Positive: Pain in the sacroiliac joint
   
   1. Indicates: Mechanical problem of the sacroiliac joint

Question 9

Gaenslen Test

Answer 9

• Positive: Pain on the affected sacroiliac joint stressed into extension
  
  • Indicates: General sacroiliac joint lesion, anterior sacroiliac ligament sprain or inflammation of the sacroiliac joint

Question 10

Lewin-Gaenslen Test

Answer 10

• Positive: Pain on the affected sacroiliac joint stressed into extension
  
  • Indicates: General sacroiliac joint lesion, anterior sacroiliac ligament sprain or inflammation of the sacroiliac joint

Question 11

Hibb Test

Answer 11

1. Positive: Pain in the hip region
   
   • Indicates: Hip joint pathology
2. Positive: Pain in the buttock/pelvic region
   
   • Indicates: Sacroiliac joint lesion

Question 12

Ober Test

Answer 12

• Positive: Affected thigh remains in abduction (normal biomechanics, the thigh/hip will adduct)
  
  • Indicates: Contraction of the iliotibial band or tensor fascia lata (usually secondary to synovitis of the hip, secondary to trauma of the gluteus medius and maximus)

Question 13

Pelvic Rock Test

Answer 13

• Positive: Pain in either sacroiliac joint
  
  • Indicates: Sacroiliac joint lesion

Question 14

Iliac Compression Test

Answer 14

• Positive: Pain in either sacroiliac joint
  
  • Indicates: Sacroiliac joint lesion

Question 15

Nachlas Test

Answer 15

• Positive: Pain in the buttock and/or pain in the lumbar region
  
  • Indicates: Sacroiliac joint lesion or lumbar pathology

Question 16

Yeoman Test

Answer 16

• Positive: Pain deep in the sacroiliac joint
  
  • Indicates: Sprain of the anterior sacroiliac ligaments

Question 17

Ely Sign

Answer 17

• Positive: Hip on side being tested will flex causing the buttock to raise off the table
  
  • Indicates: Rectus femoris or hip flexor contracture

Question 18

Ely Test

Answer 18

• Positive: Hip will flex causing the buttock to raise off the table
  
  • Indicates: Rectus femoris or hip flexor contracture

Question 19

Ely Heel to Buttock Test

Answer 19

1. Positive: Inability to raise the thigh
   
   • Indicates: Iliopsoas spasm
2. Positive: Pain in the anterior thigh
   
   • Indicates: Inflammation of the lumbar nerve roots
3. Positive: Pain in the lumbar region
   
   • Indicates: Lumbar nerve root adhesions

Question 20

Trendelenburg Test

Answer 20

• Positive: High iliac crest on supported side and low crest on same side of elevated leg
  
  • Indicates: Weak gluteus medius muscle on the supported side