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Musculoskeletal Pt. Mgmt. I - Special Tests > Practical 2 - Hip > Flashcards

Practical 2 - Hip Flashcards

1
Q

Inferior Glide

A

Patient in Supine

painful leg - knee is flexed. use your shoulder to stabilize the knee, don’t want to abduct hip. approximate adductor/quads before oscillations. you are pulling down (away from pt like towards their feet if that makes sense - inferior).

for abduction

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2
Q

Anterior Glide

A

Patient in prone, leg off the table

painful leg is slight flexion, slight abduction, PT hand is on distal buttock – not on ischial tube. support hand on or just below knee and can slightly externally rotate. push in straight anterior direction

for external rotation + extension

**if patient has limited or decreased extension, you can bring pt into extension (hold the leg or add a towel or something under the thigh) and apply anterior pressure.

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3
Q

Posterior Glide

A

patient in supine

painful leg is abducted, you (PT) sitting on the table inside the leg, hand on the inside of the thigh. flexed to 30°, abducted 30°, external rotation. hand support under the knee. pushing down posterolaterally.

for limited flexion and internal rotation.

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4
Q

Long Axis Distraction

A

Patient in Supine

Painful leg flexed to 30°, abducted 30°, external rotation. Hold around both malleoli and pull.

Helpful for generalized loss of motion, arthritis.

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5
Q

Lateral (Short Axis) Traction

A

Patient in Supine

painful leg - knee is flexed. use your shoulder to stabilize the knee, don’t want to abduct hip. approximate adductor/quads before oscillations. you are pulling into you.

for generalized loss of motion.

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6
Q

what grade mobs for pain vs increasing motion

A

1 & 2 to decrease pain

3 & 4 to increase motion

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7
Q

what tests are assessing Joint Integrity (9)

A
  • Flexion-Adduction
  • Flexion-Adduction-Axial Compression Test
  • Internal Rotation-Flexion-Axial Compression Test
  • Internal Rotation Load/Grind Test
  • Fitzgerald Test
  • Scour (Quadrant) Test
  • Flexion-Abduction-External Rotation (FABER) Test (Patrick Test)
  • Craig Test
  • Log Roll Test
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8
Q

for joint integrity, what is the Flexion-Adduction Test looking for?

A

hip dysplasia, FAI, piriformis syndrome (posterior symptoms)

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9
Q

how do you perform the Flexion-Adduction

A

patient position: supine

steps: knee flexed to 90°, adduct the thigh toward opposite hip.

positive test: inability to adduct the flexed hip past midline to opposite hip

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10
Q

what is the Flexion-Adduction-Axial Compression Test looking for?

A

labral degeneration, fraying, or tearing

Adolescents
- Hip dysplasia
Adult population
- Piriformis irritation
- FAI
- Iliopsoas

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11
Q

how do you perform the Flexion-Adduction-Axial Compression Test

A

patient position: supine

steps: passively combine hip flexion, internal rotation, and adduction

positive test: reproduction of pain/discomfort in the groin

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12
Q

what is the Internal Rotation-Flexion-Axial Compression Test looking for?

A

labral degeneration, fraying, or tearing

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13
Q

how do you perform the Internal Rotation-Flexion-Axial Compression Test

A

patient position: supine

steps: passively combine hip flexion, internal rotation, and axial compression (longitudinally thru femur)

positive test: reproduction of pain/discomfort in the groin

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14
Q

what is the Internal Rotation Load/Grind Test looking for?

A

Labral pathology

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15
Q

how do you perform the Internal Rotation Load/Grind Test

A

patient position: supine

steps: hip flexed to 100°, passive IR/ER while pushing
along long axis of femur

positive test: reproduction of pain/discomfort in the groin

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16
Q

what is the Fitzgerald Test (Anterior/Posterior Labrum) looking for?

A

labral pathology (tears)

17
Q

how do you perform the Fitzgerald Test (Anterior Labrum)

A

patient position: supine

steps: passively moves hip into combined motions of full flexion, external rotation, abduction. THEN extends hip with combined motion of internal rotation and adduction.

positive test: reproduction of pain with/without a click

18
Q

how do you perform the Fitzgerald Test (Posterior Labrum)

A

patient position: supine

steps: passively moves hip into combined motions of full extension, external rotation, abduction as starting point. THEN flexes hip combined with adduction and internal rotation.

positive test: reproduction of pain with/without a click

19
Q

what is the Scour (Quadrant) Test looking for?

A

Articular surfaces (OA)
Labrum (Tear/FAI)
Joint capsule
Iliopsoas (Acute/Chronic Strain)
Femoral neck

20
Q

how do you perform the Scour (Quadrant) Test

A

patient position: supine

steps: flexes knee and provides axial load through femur. then performs sweeping compression and rotation movement from external-internal rotation

positive test: pain or apprehension at any given point during test

21
Q

what is the Flexion Abduction External Rotation (FABER) Test (Patrick Test) looking for

A

Hip pathology
Labrum OA
Iliopsoas
Capsule
Sacroiliac joint dysfunction

22
Q

what is the Craig Test looking for

A

anteversion / retroversion

8-15° normal

<8° = anteversion
>15° = retroversion

23
Q

how do you perform the Craig Test?

A

patient position: prone

steps: involved knee flexed to 90° and palpates greater troch until its most lateral, then uses goni to get measurement of ER/IR.

positive test:
<8° = anteversion
>15° = retroversion

24
Q

what is the log roll test for

A

a click reproduced during this test is suggestive of labral tear
or
increased external rotation range-of-motion may indicate iliofemoral ligament laxity.

25
Q

how do you perform the log roll test

A

patient position: supine

steps: grasps LE to be tested at distal femur. passively rolls LE into full IR and ER.

positive test: click = labral tear, increased ER = iliofemoral ligament laxity

26
Q

what tests are assessing strength (2)

A
  • Trendelenburg Sign
  • Resisted Straight Leg Raise
27
Q

what is the Trendelenburg Sign looking for

A

Legg-Calves Perthes (+ Trendelenburg required for dx)

glute med weakness

28
Q

how to perform the Trendelenburg Sign

A

patient position: standing

steps: tell pt to stand on one leg, PT evaluates degree of drop of contra-lateral pelvis once leg is lifted.

confirmation needed of abnormal pelvic drop during gait

positive test: asymmetric drop of one hip

29
Q

what is the Resisted Straight Leg Raise Test looking for

A

possible peritoneal inflammation, appendicitis, or inflammation of the iliopsoas

30
Q

how to perform the Resisted Straight Leg Raise

A

patient position: supine

steps: PT places hand on thigh of painful LE. raises painful LE 30cm off plinth. PT applies downward force at distal thigh and pt resists.

positive test: reproduction of pain in lower quadrant

31
Q

how to perform the Thomas Test

A

patient position: sitting at edge of table

steps: tell pt to lie back pulling both knees to chest. hold UNaffected knee to chose and affected knee is dropped and slowly lowered into extension.

positive test: significant tightness of hip flexors

31
Q

what tests are assessing Flexibility (2)

A
  • Thomas Test
  • Ober Test
32
Q

what is the Thomas Test looking for

A

hip flexor tightness

33
Q

how to perform the Ober Test

A

patient position: side lying w/ symptomatic leg facing up

steps: PT puts knee into flexion. PT stabilizes the pelvic at iliac crest. guides LE at hip into extension and slight abduction. use goni to measure add/abd

positive test: failure of knee to drop to plinth

33
Q

what is the Ober Test looking for

A

tightness of ITB and TFL

34
Q

what tests are assessing Fractures (1)

A

Fulcrum Test

35
Q

what is the Fulcrum Test looking for

A

femoral shaft stress fracture

36
Q

how to perform the Fulcrum Test

A

patient position: sits with (B) over edge of table

steps: PT places one forearm under pt’s thigh to be tested. gentle pressure applied to dorsum of knee

positive test: if pt reports increased discomfort/sharp pain + apprehension

Musculoskeletal Pt. Mgmt. I - Special Tests (4 decks)

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