Clinical Scenario
This patient has pain in the right hip - Examine the hip
→ Stand beside the affected side
Examination Checklist
| Item | Procedure |
|---|---|
| Look | General statement on the patient |
| General on hip: Position/Swelling & deformity/Attitude & extra | |
| Anatomical: skin, subcutaneous | |
| Muscles: Quadriceps, Gluteus Maximus | |
| Bony landmarks: ASIS, Iliac crest, Lumbar lordosis | |
| Feel | Look at the back |
| Tenderness: Generalized / Specific points of tenderness | |
| Bony landmarks: ASIS, Iliac crest, Lumbar lordosis Muscles: gluteus medius, maximus, rectus,… | |
| Temperature: Compare both sides, proximal and distal | |
| Move | Muscles: Quadriceps, Gluteus Maximus |
| Active: General screening for pain Gait: | |
| Special tests | Abduction/Adduction (compare with other side): (orlanti barlow) Both together Anchor one side at edge of table Hold ASIS |
| Flexion (compare with other side): Anterior aspect of thigh should touch the abdomen - | |
| Extension (compare with other side) - fix pelvis at side, perform. - | |
| External/Internal rotation: In extension (both together) at 90* stabilize pelvis, then rotate | |
| External/Internal rotation: In flexion (compare with other side) | |
| Thomas test: fixed flexion deformity if other leg raised, 30* | |
| Trendelenburg test: gluteus medius | |
| Leg length: True/Apparent Choose bony landmark Apparent when measured from above ASIS Difference may be due scoliosis True ASIS ⇒ Medial malleolus | |
| Gait: Walking | |
| Thank the patient; Attitude with patient |
place hand at lumbar area, whilist flexing leg - - starts from 20-x*