This article contains
instructions, advice, or how-to content. (December 2019) |
In medicine, physiotherapy, chiropractic, and osteopathy the hip examination, or hip exam, is undertaken when a patient has a complaint of hip pain and/or signs and/or symptoms suggestive of hip joint pathology. It is a physical examination maneuver.
The hip examination, like all examinations of the joints, is typically divided into the following sections:
The middle three steps are often remembered with the saying look, feel, move.
Position – for most of the exam the patient should be supine and the bed or examination table should be flat. The patient's hands should remain at their sides with the head resting on a pillow. The knees and hips should be in the anatomical position (knee extended, hip neither flexed nor extended).
Lighting – adjusted so that it is ideal.
Draping – both of the patient's hips should be exposed so that the quadriceps muscles and greater trochanter can be assessed.
Look
Front and back of pelvis/hips and legs and comment on
Feel
Move·
Gait: Observe
Abnormal Gait Patterns
The hip should be examined for:
In hip fractures the affected leg is often shortened and externally rotated.
The hip joint lies deep inside the body and cannot normally be directly palpated.
To assess for pelvic fracture one should palpate the:
Romberg's test This assesses proprioception/balance (dorsal columns of spinal cord/spino-cerebellarpathways).
Kaltenborn test or Hip Lag Sign for hip abductor function. To perform the Kaltenborn test, the patient has to lie in a lateral, neutral position with the affected leg being on top. The examiner then positions one arm under this leg to have good hold and control over the relaxed extremity, whereas the other hand stabilizes the pelvis. The next step is to passively extend to 10° in the hip, abduct to 20° and rotate internally as far as possible, while the knee remains in a flexed position of 45°. After the patient is asked to hold the leg actively in this position, the examiner releases the leg. The Hip Lag Sign is considered positive if the patient is not able to keep the leg in the aforementioned abducted, internally rotated position and the foot drops more than 10 cm. To ensure an accurate result, the test should be repeated three times. [2]
A knee examination should be undertaken in the ipsilateral knee to rule-out knee pathology.
This article contains
instructions, advice, or how-to content. (December 2019) |
In medicine, physiotherapy, chiropractic, and osteopathy the hip examination, or hip exam, is undertaken when a patient has a complaint of hip pain and/or signs and/or symptoms suggestive of hip joint pathology. It is a physical examination maneuver.
The hip examination, like all examinations of the joints, is typically divided into the following sections:
The middle three steps are often remembered with the saying look, feel, move.
Position – for most of the exam the patient should be supine and the bed or examination table should be flat. The patient's hands should remain at their sides with the head resting on a pillow. The knees and hips should be in the anatomical position (knee extended, hip neither flexed nor extended).
Lighting – adjusted so that it is ideal.
Draping – both of the patient's hips should be exposed so that the quadriceps muscles and greater trochanter can be assessed.
Look
Front and back of pelvis/hips and legs and comment on
Feel
Move·
Gait: Observe
Abnormal Gait Patterns
The hip should be examined for:
In hip fractures the affected leg is often shortened and externally rotated.
The hip joint lies deep inside the body and cannot normally be directly palpated.
To assess for pelvic fracture one should palpate the:
Romberg's test This assesses proprioception/balance (dorsal columns of spinal cord/spino-cerebellarpathways).
Kaltenborn test or Hip Lag Sign for hip abductor function. To perform the Kaltenborn test, the patient has to lie in a lateral, neutral position with the affected leg being on top. The examiner then positions one arm under this leg to have good hold and control over the relaxed extremity, whereas the other hand stabilizes the pelvis. The next step is to passively extend to 10° in the hip, abduct to 20° and rotate internally as far as possible, while the knee remains in a flexed position of 45°. After the patient is asked to hold the leg actively in this position, the examiner releases the leg. The Hip Lag Sign is considered positive if the patient is not able to keep the leg in the aforementioned abducted, internally rotated position and the foot drops more than 10 cm. To ensure an accurate result, the test should be repeated three times. [2]
A knee examination should be undertaken in the ipsilateral knee to rule-out knee pathology.