Hip Exam

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Hip Exam

Patient down to underwear

Standing inspection -

Look for :

1) Tilted pelvis

2) Exagerated lubar lordosis

3) Abscesses

4) Skin changes

5) Wasting of thigh muscles

6) Scars

Trendelenburg Test ->

Stand in front of the patient, lightly supporting their hands. Ask them to stand on one leg for 30 secs. Should see a rise in the ilac crest. If iliac crest drops below the horizontal it is abnormal (positive). Repeat on the other side.

(positive would be weak gluteal muscles, OA hip pain, structural abnormality of hip joint)

Patient lie supine on bed.

Feel temperature

Fell greater trochanter, ASIS, mid inguinal point. Note tenderness

Measures leg length from ASIS to medial malleolus on each side. Actual leg length

Measures leg length from Umbilicus to medial Malleolus on each side. Apparent leg length

Active hip flexion and extension both sides. Pateint to bring knee to their chest as far as possible.

Support ASIS, active leg abduction and adduction.

Passive hip flexion and extension.

Passive hip abduction and adduction.

Passive hip internal and external rotation.

Resisted hip flexion and extension.

Resisted hip abduction and adduction.

Thomas' Test- one hand under the lumbar spine to monitor its positiion. Flex left hip passively as far as it will go and maintain. Check lumbar spine is now flat. Can right leg now be straightened flat onto the bed.

(if not problem with the right leg- fixed flexion deformity)

Repeat as above with opposite legs.

Related= spine, knee, lower limb neurovascular exam