Orthopedics- Pelvis and hip lab Flashcards
Describe Belt test, what is a (+), what could a (+) indicate?
1st pt bends forward and touches toes, sxs?
If pain/sxs are noted by pt then the examiner stabilizes sacrum against lateral thigh, grasps iliac crests BL and asks pt to touch their toes (as much as they can) again
(+)= low back pain provoked during both parts= lumbar origin
(+) with only touching their toes indicates sacroiliac origin
(+)= blocking of SI jt should provide a relief of SI sxs, if pt still has pain w/blocking then lumbar in origin
Describe Yeoman’s test, what is a (+), what could it indicate? what is it a test for?
pt is prone
flex pts knee to 90 deg, stabilize SI by putting pressure over PSIS, PIIS
lift knee to extend hip only (not low back)
(+)= pain in SI, dermatomal pain in anterior part of thigh could be nerve sensitivity or rectus femoris sensitivity or hip pain
can be used to stretch and assess the femoral nerve, SI joint or hip
Describe Patrick’s test, what is it also known as, what is a (+), what could it indicate?
aka FABER test (flexion, abduction, external rotation of the hip)
place leg in figure-4 position w/resting foot just above opposite knee, use one hand to stabilize the opposite ASIS and the other hand to apply gentle downward pressure over flexed kneed to move hip into extension
(+)= sxs in trochanter, groin, back, SI area
if sxs in trochanter or groin indicates hip
if sxs in back, SI area indicates SI joint
Describe Anvil test, what is a (+), what can it indicate?
Pt supine w/legs extended on table, examiner stabilizes ankle and percusses calcaneus briskly and vigorously, start light, then moderate, then hard
(+)= pain; if exquisite and felt in hip jt could be acetabulofemoral joint pathology or fracture or pain n hip or all up and down the leg if a fracture somewhere
Describe the Hip Scouring test, what is a (+), what could it indicate?
position pts hip into internal rotation + adduction and axial compression, maintaining the internal rotation and axial compression perform an arc toward flexion and abd w/pts hip
(+)= reproduction of pain; if intra-articular lesion or labral tear will be pain or clunking, respectively
Describe Thigh thrust test, what is a (+), what could it indicate?
symptomatic leg, hip flexed and knee flexed at 90 deg, examiner applies compressive force directly down femur
(+)= localized pain in SI joint
could indicate SI jt pathology
Describe SI distraction test, what is a (+), what could it indicate?
pt on back, contact points on both ASIS jts, crossed hands, push on both, pushing inominates away from e/c
(+)= localized pain in SI jts
could indicate SI jt pathology
Describe Sacral Thrust test, what is a (+), what could it indicate?
pt is prone, push on SI joint PA, tests spring joint
(+)= pain in SI jt
Describe Gaenslin’s test, what is a (+), what could it indicate?
Pt hugs symptomatic knee, other leg will be off the table, examiners hands are on pts hugged knee along with other hand on knee of leg off the table, apply pressure to leg off table only if no sxs when originally put into this position
(+)= localized SI sxs or hip pain b/c also testing the femoral & obturator nerves
Describe SI Joint Compression test
pt side lying, hips stacked w/knees slightly bent, contact should be palm, hands-width posterior to ASIS on the innominate, force MP
(+)= pain in SI joint
just tells us that the nervous system is detecting a threat in the SI area
5 tests for SI irritation
SI joint compression test Sacral thrust Thigh thrust SI joint distraction Gaenslen's test
Describe Active SLR test, what a (+) is and what it could mean
have pt lift leg up 4” off the table and assess for pain, if no pain then add some resistance, if still no pain then have them lift it to 8” and repeat
(+)= if pain at either height and with resistance then tells you they’re having SI jt forced closure problems; if pain at either height and compression provides relief tells you musculature is not working correctly
cluster 1 for diagnosing OA of the hip
pain in the hip (not SIJ)
less than 115 deg of hip flexion
less than 15 deg of IR of hip
cluster 2 for diagnosing OA of the hip
pain with hip IR
>60 min of AM stiffness
>50 yo
