HIP JOINT examination

 

HIP JOINT examination

Standing (gait)

  • Trendelenburg gait
  • Antalgic gait

Look

(inspection)

Feel

(palpation)

Move

Measure / special tests

  1. from back & sides :
    1. skin
    2. subcutaneous
    3. muscle (gluteal wasting)
  2. from back: bones pelvic tilt, iliac crests & PSIS and compensatory scoliosis of spin (ADDuction deformity)
  3. from side: exaggerated lumber lordosis flexion deformity
(gentle and rapid)

  • Temperature
  • Tenderness
  • Hip joint gently from front
  • trochanteric area Bursitis

Supine

Repeat palpation

Supine

Active & Passive (fix the pelvis and compare with the other side)

Thomas test fixed flexion deformity

Flexion  from 0 to 140

Extension from 0 to 10

Abduction from 0 to 45

Adduction from 0 to 30

External rotation from 0 to 40

Internal rotation from 0 to 40

Against resistance

Full range vs. limited range

Painful vs. painless

Trendelenburg test defective ABDuctor mechanism

(SSS) Sound Side Sages

MEASURE

  • REAL length

from ASIS to medial malleolus for shorting of femur or tibia

Galleazzia sign

Bryant’s test

  • APPARENT length

from Xiphisternum to medial malleolus

short side with normal real length –> ADDuction deformity

Examination of joint above and joint below

Examination of sensory and motor innervations

Examination of peripheral circulation

 

NOTE

Galleazzia sign [shortening in the femur or tibia] Flex the hip to 45º and knee in 90º Any shortening in the femur or tibia

Bryant’s test  Determines whether the shortening in the supra-trochanteric or infra-trochanteric.  Is the perpendicular distance from the line drawn from the ASIS This gives Supratrochanteric distance. It is a comparative test [compare with the contralateal side]