Hip physical examination

May 7, 2009 by David Fitzgerald | | Print
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1. STANDING

Observation

From behind:

lower limb rotation/ position of feet

knee creases

gluteal fold

PSIS

muscle bulk

spine

leg length

From side:

pelvic rotation

lumbar spine

From in front:

lower limb rotation

Q angle -

level of patellae

quadriceps bulk

ASIS

Functional tests and tests for other joints

walking forwards and backwards

flex knee to chest

squat (may add overpressure)

rotate trunk and pelvis while standing on one leg

(medial and lateral rotation).

Steps

Hopping

Running

sitting to standing

lumbar spine, combined movements.

Neurological

muscle power, reflexes, sensation as appropriate

2. SUPINE LYING

Observation

leg length

lower limb rotation

Palpation

temperature changes

swelling and thickening

Neurological

muscle power, reflexes, sensation as appropiate.

Active Movement

Flexion

Abduction / Adduction

Lateral rotation / Medial rotation (in neutral and /or 90º flexion)

Resisted or static tests

Flexion (performed in neurological test).

Abduction /Adduction

Lateral rotation/medical rotation (in 90ºflexion)

Muscle function

Iliopsoas, quadriceps, tensor fascia lata, hamstrings

Adductor length and differentiation.

Tests for other regions and structure

sacroiliac joints

knee

Passive movements: Passive physiological movements

Flexion

Abduction

Lateral rotation /Medial rotation (in neutral and 90º flexion)

Combined physiological movements

Flexion – Adduction

(special test performed from 90-140º flexion)

Flexion – Abduction – External rotation

Passive accessory Movements

Longitudinal distraction in extension

Longitudinal distraction in 90º flexion

Lateral distraction in 90º flexion (may be performed in any combined position)

3. SIDE LYING: Passive Accessory Movements