Hip examination

Hip examination

In medicine, 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:
*Position/lighting/draping
*Inspection
*Palpation
*Motion
*Special maneuvers

The middle three steps are often remembered with the saying "look, feel, move".

Position/Lighting/Draping

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 her sides with her 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.

Inspection

Inspection done while the patient is standing

The hip should be examined for:
*Abnormal gait - i.e. antalgic gait

Inspection done while supine

The hip should be examined for:
*Masses
*Scars
*Lesions
*Signs of trauma/previous surgery
*Bony Alignment (rotation, leg length)
*Muscle bunk and symmetry at the hip and knee

Measures

*True leg length - anterior superior iliac spine (ASIS) to medial malleolus
*Apparent leg length - umbilicus to medial malleolus

In hip fractures the affected leg is often shortened and externally rotated.

Palpation

The hip joint lies is deep and cannot normally be directly palpated.

To assess for pelvic fracture one should palpate the:
*Ischial spines
*Pubic rami

Movement

*Internal rotation - with knee and hip both flexed at 90 degrees the ankle is abducted.
*External rotation - with knee and hip both flexed at 90 degrees the ankle is adducted.
*Flexion
*Extension - done with the patient on their side. Alignment should be assessed by palpation of the ASIS, PSIS and greater trochanter.
*Abduction - assessed whilst palpating the contralateral ASIS.
*Adduction - assessed whilst palpating the ipsilateral ASIS.

*Assessment for a hidden flexion contracture of the hip - hip flexion contractures may be occult, due to compensation by the back. They are assessed by:
*# Placing a hand behind the lumbar region of back
*# Getting the patient to fully flex the contralateral hip.
*# The hand in the lumbar region is used to confirm the back is straightened (flexed relative to the anatomic position). If there is a flexion contracture in the ipsilateral hip it should evident, as the hip will appear flexed.

Normal range of motion

*Internal rotation - 35°
*External rotation - 45°
*Flexion - 135°
*Extension - 15°
*Abduction - 45°
*Adduction - 25°

pecial maneuvers

*Trendelenburg testtelescoping axial movement is tested with knee bent 90 degrees and lying on couch.tests for dislocation

Other tests

A knee examination should be undertaken in the ipsilateral knee to rule-out knee pathology.

ee also

*Anatomical terms of location
*Anatomical terms of motion

External links

* [http://www.gpnotebook.co.uk/cache/1798635535.htm Trendelenburg test] - gpnotebook.co.uk.
* [http://www.ori.org.au/bonejoint/hip/examination.htm Clinical Hip Examination] - Orthopaedic Research Institute Australia.


Wikimedia Foundation. 2010.

Игры ⚽ Поможем написать реферат

Look at other dictionaries:

  • Hip — For other uses of the term, see hip (disambiguation). Hip (anatomy) Bones of the hip Latin coxa Gray s …   Wikipedia

  • Hip fracture — DiseaseDisorder infobox Name = Hip fracture ICD10 = ICD10|S|72|0|s|70 ICD9 = ICD9|820 A hip fracture is a fracture in the proximal end of the femur (the long bone running through the thigh), near the hip joint.The term hip fracture is commonly… …   Wikipedia

  • Physical examination — Intervention Examination room in Washington, DC, period of WWI. ICD 9 CM …   Wikipedia

  • Mental status examination — Intervention ICD 9 CM 94.09, 94.11 The mental status examination in the USA or mental state …   Wikipedia

  • Neurological examination — Intervention The human nervous system ICD 9 CM …   Wikipedia

  • Rectal examination — Intervention Digital rectal exam: side view of the male reproductive and urinary anatomy, including the prostate, rectum, and bladder. ICD 9 CM 89.34 …   Wikipedia

  • Bone marrow examination — Diagnostics A Wright s stained bone marrow aspirate smear from a patient with leukemia. MeSH …   Wikipedia

  • Mini–mental state examination — Not to be confused with Mini international neuropsychiatric interview. The mini–mental state examination (MMSE) or Folstein test is a brief 30 point questionnaire test that is used to screen for cognitive impairment. It is commonly used in… …   Wikipedia

  • Knee examination — The knee examination, in medicine, is performed as part of a physical examination, or when a patient presents with knee pain or a history that suggests a pathology of the knee joint.The exam includes several parts: *position/lighting/draping… …   Wikipedia

  • Cranial nerve examination — The cranial nerve exam is part of the neurological examination. It is used to identify problems with the cranial nerves by physical examination. Contents 1 Components 2 See also 3 References 4 …   Wikipedia

Share the article and excerpts

Direct link
Do a right-click on the link above
and select “Copy Link”