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    Hip Examination

    Uploaded by

    Srikanth
    Hip joint examination

    Copyright:

    © All Rights Reserved
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    Hip Examination

    Uploaded by

    Srikanth
    23 views25 pages
    Hip joint examination

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    © © All Rights Reserved

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    PPT, PDF, TXT or read online from Scribd

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    Hip joint examination

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    23 views25 pages

    Hip Examination

    Uploaded by

    Srikanth
    Hip joint examination

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 25

    HIP EXAMINATION

    Basic Principles
    ( Prerequisites of Examination )

     Patient must be suitably undressed.

     Hard bed.
    Pattern of Examination
     Inspection.
     Palpation.
     Movements.
     Measurements.
     Special tests.
    Inspection
     Standing position.

     Lying down position.


    Inspection (contd)
    In standing position
     Patient able to stand – Yes / No.
     If yes, patient able to walk – Yes / No.
     If yes, check Gait.
     Gait :
    – Trendelenburg.
    – Antalgic
    – Waddling
    – Short legged
    – High stepping
     Patient able to squat or not.
    Inspection (contd)
    In standing position

     Trendelenburg test
    Inspection (contd)
    In standing position
     Spine.
     Wasting eg Disuse atrophy, neurological
    deficit.
     Swelling eg Cold abscess, dislocation, lipoma.
    – Scarpas triangle.
    – Greater trochanter.
    – Gluteal region
     Scars / Sinus
     Level of natal fold eg CDH.
    Inspection (contd)
    In lying down position

    Sequential -
    Top to bottom
    or
    Bottom to top.
    Inspection (contd)
    In Lying down position
     Attitude.

     Lumbar lordosis.

     ASIS.

     Greater trochanter
    – Position
    – Prominence
    Inspection (contd)
    In Lying down position
     Scarpas triangle
    – Fullness.
    – Scars / sinus.
     Skin
    – Colour, texture, prominent veins.
     Thigh
    – Wasting.
     Patella
    – Position
    Inspection (contd)
    In Lying down position
     Calf
    – Wasting
     Malleoli
    – Level
    – Direction.
     Heel
    – Level
     SLR
    Palpation
    Confirmation of inspection findings in same
    sequence plus few additions :
    Temperature, Tenderness & Telescopy

     Lumbar lordosis
    – Thomas’s test for FFD.
    Palpation (contd.)
     ASIS level
    – How to feel ?
    – Level.

     Greater trochanter
    – Position, Promince (Bitrochanteric test).
    – Tenderness – Antero posterior / Axial.
    Palpation ( contd. )
     Temperature
     Scars
     Sinuses :
    – Margins, Discharge, adherence to bone
     Tenderness
     Circumference of thigh / calf
     Medial malleolus
    – How to feel?
    – Level & direction
     Heel
    – Level
    Palpation ( contd. )
     Telescopy
    Movements
    Sagittal Flexion 0-90 ext knee
    0 – 120 fl knee
    Extension 0 -15
    Coronal Adduction 0 – 30
    Abduction 0 - 40
    Vertical External 0 – 45
    Internal 0 – 30
    rotation.

    Circumduction Incomplete

    In fixed deformities, starting point will be the degree of deformity


    Measurements
    Apparent : Lengthening / Shortening.

     Pre requisite
    – Limbs parallel

     Measured between midline point -


    xiphisternum, manubrium sterni or umbilicus
    &
    medial malleoli
    Measurements
    Real : Lengthening / Shortening

     Pre requisites
    – Squaring of pelvis.
    • ASIS at same level.
    – Limbs in identical position.

     Measurement from ASIS to medial


    malleolus.
    Measurements ( contd )

     Find level of discrepancy


    – Leg,

    – Thigh or

    – Supratrochanteric.
    Measurements( contd )
    (How to detect supratrochanteric
    shortening)
     Bryants triangle.

     Nelaton’s line.
    Measurements ( contd )
    (How to detect supratrochanteric
    shortening
     Schoemaker’s line.

     Chiene’s parallelogram
    Special Tests
     Narath’s vascular sign.

     Ortolani’s test.
     Barlow’s test.

     Ely’s test.
    Examination (contd)

     Examination of hip is incomplete without


    examination of spine & knee.
    Key to Examination findings
    ASIS at same No adduction or Apparent
    level abduction measurements =
    deformity Real
    measurements
    ASIS raised Adduction Apparent
    deformity shortening >
    Real shortening
    ASIS lower Abduction Apparent
    deformity lengthening >
    Real
    lengthening

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