OSCE: Hip Flashcards
What are important anterior landmarks of the hip?
- Level of L4: Iliac Crest (upper margin of pelvis)
- Iliac Tubercle and Anterior Superior Iliac Spine (ASIS)
- Greater Trochanter of Femur
- Pubic Tubercle
What are important posterior landmarks of the hip?
- Posterior Superior Iliac Spine (PSIS)
- Greater Trochanter of Femur
- Ischial Tuberosity
What is the normal ROM for hip flexion (knee flexed)/ knee extended?
What muscles are involved?
120-135o
90 if knee is extnded
Iliopsoas (femoral nerve L2-L4)
What is the normal ROM for hip extension?
What muscles are involved?
15-30o
Gluteus Maximus (inferior gluteal nerve L5-s2)
What is the normal ROM for hip abduction?
What muscles are involved?
45-50o
Gluteus Medius and Minimus (superior gluteal nerve l5-s1)
What is the normal ROM for hip adduction?
What muscles are involved?
20-30o
Medial Compartment Muscles: Adductor Longus, Brevis, and Magnus, Pectineus, Gracilis
What is the normal ROM for hip external rotation?
What muscles are involved?
40-60o
sartorious, glute medius, glut max
What is the normal ROM for hip internal rotation?
What muscles are involved?
30-40o
Iliopsoas
Labral Loading
What compartment is this testing?
How do you peform this test?
What does a positive test indicate?
Central Compartment
- Flex the patient’s knee and hip to 90°
- Load into the femur towards the innominate (hip bone)
- Positive Test (pain) indicates Labral or Cartilaginous Pathology
Labral Distraction
What compartment is this testing?
How do you peform this test?
What does a positive test indicate?
Central Compartment
- Flex the patient’s knee and hip to 90°
- Distract femur away from the innominate
Positive Test (distraction of pain) indicates Labral or Cartilaginous Pathology
Scour
What compartment is this testing?
How do you peform this test?
What does a positive test indicate?
Central Compartment
- Flex and externally rotate patient’s hip.
- Load into socket and articulate through annular range of motion.
Positive Test (pain) indicates Labral or Articular Cartilage Pathology
Apprehension Faber
What compartment is this testing?
How do you peform this test?
What does a positive test indicate?
FABER 1 OF 3
Central Compartment
- Patient’s hip is flexed, abducted and externally rotated.
- Physician induces further external rotation by applying a posterior force at the knee.
Positive Test (anterior subluxation of hip or pain) indicates Labral Pathology
Jump sign
What compartment is this testing?
How do you peform this test?
What does a positive test indicate?
Lateral Compartment
- Patient seated.
- Pressure is applied to greater trochanter.
Positive Test (patient jump) indicates Trochanteric Bursitis
Straight Leg Raise Test
What compartment is this testing?
How do you peform this test?
What does a positive test indicate?
Lateral Compartment
- Patient supine.
- Passively flex patient’s ipsilateral hip with knee extended.
Positive Test (pain over lateral leg at >15o) indicates IT Band contracture
- Positive signs usually occur between 30-60˚ if cause is lumbosacral radiculopathy and/or sciatic neuropathy.
- Positive signs at >70˚ is more likely mechanical low back pain due to muscle strain or joint disease.
Patrick’s Faber (Lateral Compartment)
How do you peform this test?
What does a positive test indicate?
Lateral Compartment
- Patient’s hip is flexed, abducted and externally rotated.
- Physician braces contralateral ASIS.
- Patient externally rotates/abducts against resistance.
Positive Test (pain) indicates Gluteus Medius Pathology
Patrick’s Faber (Anterior Compartment)
How do you peform this test?
What does a positive test indicate?
Anterior Compartment
- Patient’s hip is flexed, abducted and externally rotated.
- Physician braces contralateral ASIS.
- Patient internally rotates/adducts against resistance.
Positive Test (pain) indicates Iliopsoas Insufficiency or Pathology
