Special Orthopedic Test : Hip

Question 1

Hip Scour Test

Answer 1

Process :
1. Patient supine; examiner flexes adn adducts patient’s hip so it faces opposite shoulder and resistance to the movement is felt
2. Slight resistance maintained; hip taken into abduction while maintaining flexion in an arc of movement
+ve Sign : Irregularity in the movement (ex. bumps), pain or apprehension
+ve Indicates : Impingement of femoral neck against acetabular rim; pinching of adductor longus, pectineus, iliopsoas, sartorius, and/or TFL

Question 2

Patrick’s Test (FABER or Figure 4 Test)

Answer 2

Process :
1. Client supine; examiner places test leg so that foot is on top of opposite knee & then slowly lowers knee toward table, stabilizing opposite hip
+ve Sign : Knee remains above opposite straight leg and/or pain at SI
+ve Indicates : Iliopsoas spasm and/or anterior SI ligament sprain

Question 3

Heel Strike Test

Answer 3

Process :
1. Patient supine
2. Examiner firmly strikes the heel to stimulate heel strike during walking
+ve Sign : Pain in the groin
+ve Indicates : Femoral neck stress fracture

Question 4

Ely’s Test (Tight Rectus Femoris, Method 2)

Answer 4

Process :
1. Client prone
2. Examiner observes pelvis while bringing calcaneus to glutes
+ve Sign : Hip spontaneously flexes
+ve Indicates : Rectus femoris contracture/shortening

Question 5

90-90 Straight Leg Raising Test (Hamstring Contracture, Method 1)

Answer 5

Process :
1. Patient supine; flexes both hips 90 degrees with knees bent, then grasps behind knees to stabilize hips at 90 degrees, then actively extends each knee in turn as much as possible
+ve Sign :
- Knee extension not within 20 degrees of full extensio
- ASIS moves up before the thigh reaches the trunk
+ve Indicates :
- Hamstring contracture
- Short, tight gluteus maximus

Question 6

Noble Compression Test

Answer 6

Process :
1. Client supine; knee flexed 90 degrees & hip flexed
2. Examiner applies pressure to lateral femoral condyle or 1-2 cm proximal & client slowly extends knee while pressure maintained
+ve Sign : Severe pain over lateral femoral condyle at 30 degrees flexion
+ve Indicates : ITB Friction syndrome

Question 7

Ober’s Test

Answer 7

Process :
1. Client sidelying with lower leg flexed at hip & knee for stability
2. Examiner stabilizes pelvis; abducts & extends upper leg with knee straight or flexed 90 degrees, then slowly lowers leg
+ve Sign ; Leg remains abducted / does not fall below horizontal
+ve Indicates : TFL / ITB contracture

Question 8

Rectus Femoris Contracture Test (Kendall Test, Method 1)

Answer 8

Process :
1. Client supine at end of table with knees bent; flexes one knee to chest & holds it
2. Examiner observes angle at knee of leg with hip extended/flat on table
+ve Sign : Angle at knee is less than 90 degrees
+ve Indicates : Rectus femoris contracture

Question 9

Thomas Test

Answer 9

Process :
1. Client supine; examiner observes for excessive lordosis
2. Examiner flexes one hip, bringing knee to chest & client holds in knee place
+ve Sign :
- Straight leg raises off table & muscle stretch end feel is felt
- Lower limb pushed down onto table & lordosis increases
+ve Indicates : Hip flexion contracture

Question 10

Trendelenburg Test or Sgn

Answer 10

Process :
1. Client asked to balance on one leg & then the other
2. Examiner observes movement of the pelvis
+ve Sign : Pelvis on nonstance leg falls
+ve Indicates : Hip abductor weakness/instability