Hip physical examination

May 7, 2009 by   Print
Filed under Resources

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

  • Longitudinal caudad
  • PA and AP on greater trocanter

4. PRONE LYING

Neurological

  • Muscle power, reflexes, sensation as appropriate.

Active movements.

  • Extension
  • Medial rotation/ Lateral rotation

Passive movements: Passive physiological movements

  • Extension
  • Medial rotation/ Lateral rotation

Tests for other regions and structures

  • lumbar spine
  • sacroiliac joints

Palpation

  • Piriformis
  • Bursae

Muscles function

  • Hip extension  “firing “ pattern
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