W2 - MSK Hip Joint Flashcards
Subjective questions for the hip
Aags/eases (squatting, stairs & walking)
Locking or catching (indicate a FAI)
crepitus (indicates a roughening of cartilage)
Neurological symptoms
Lumbar symptoms
Red flags to ask in an MSK subjective assessment
Cancer
Infection
Stress fractures
DVT
trauma/fractures
Hip specific
Lumps/bumps in the groin area
Testicular swelling
What are the bullet point list for a hip joint objective assessment
Observation
AROM
PROM
muscle tests (strength & length)
Palpation (tissue tenderness)
Accessory movements
Special tests
Functional tests
What will be observe in a hip joint objective assessment
Posture (asymmetry, even weight bearing, use of a walking aid)
Muscle bulk (muscle atrophy or hypertrophy)
Swelling
Colour
Gail
Maladaptive patterns
What are we looking for in AROM for a hip joint objective assessment
- Range of movement (is it normal compared to the other side)
- Quality (willingness to move)
- Pain response (when & where & does it get better or worse after repeating the movement)
- Occurrence of muscle spasm
What does AROM test
Mechanical/structural
- muscles & tendon (contractile tissue)
- joijnts, ligaments & capsule (inert tissue)
- stretches & pulls
- load transfer/acceptance
Biopsychosocial
- willingness to move
- pain behaviour
- avoidance
- reluctance
- fear
What does PROM test
- Inert tissues
- Stretch contractile tissues at the end of the range
What are you looking for in a PROM
- range of motion available
- pain reproducing & resisting (where in the range)
- pattern of movement limitation
- end feel
- movement of associated joints
What would you test muscle length
Modified Thomas test
Obers test (tests lateral structures of the hip & thigh)
What accessory movements are available at the hip
AP
PA
Longitudinal caudad
Lateral distraction
What is the modified Thomas test
Tests tightness in the hip flexors
Can also be used to differentiate between tightness in the hip flexors, rectus femoris & lateral structures
What is the obers test
Initially thought to test length of the iliotibial band (ITB)
New evidence says it tests glute med and min more then the ITB
Not a reliable diagnostic test
What is the trendelenberg test
Single leg stance assessment
Positive test = drop on opposite side of the pelvis, reproduction of pain
What does a positive trendelenberg test indicate
Weakness in the hip abductors
(Proactive for gluteal tendinopathy)
Signs & symptoms of hip OA in an objective assessment
Reduced range of motion (capsular pattern)
Altered gait pattern
Signs & symptoms of a gluteal tendinopathy in an objective assessment
Pain on palpation
Pain on resisted hip abduction
Pain on stretch of the glutes
Positive trendelenberg test
