Hip Evaluation

Question 1

Self assessment for the hip

Answer 1

• lower extremity functional scale (LEFS)
• the western Ontario and McMaster universities osteoarthritis index (WOMAC)
• hip outcome score
• international hip outcome tool

Question 2

Functional screen

Answer 2

• trunk flexion
• truck extension
• single leg stance 30 secs
• squat

Question 3

ROM for flexion

Answer 3

• trunk flexion in standing
• trunk flexion in sitting
• hip flexion in sitting
• hip flexion in supine

Question 4

ROM for extension

Answer 4

• trunk extension in standing
• hip extension in standing
• hip extension in sidelying

Question 5

Longitudinal distraction

Answer 5

• 30 degrees ABD and 30 degrees flexion for open packed position
• pull on foot

Question 6

lateral distraction

Answer 6

• knee is bent and hip flexed
• pull laterally as close to the joint as you can get

Question 7

Inferior glide

Answer 7

• hip and knee is flexed at 90-90 pulling inferiorly
• improves flexion and abduction

Question 8

Posterior glide

Answer 8

• knee and hip flexed to 90 degrees with slight adduction and compress through the knee
• improves flexion and internal rotation

Question 9

Anterior glide

Answer 9

• patient prone with knee bent to 90 degrees compressing on the femoral head
• improves extension and external rotation

Question 10

Describe the Scour test

Answer 10

• test for arthritis
• patient supine close to edge of table
• flex hip to 90 degrees
• compress hip and move into flexion and adduction and again into flexion and abduction
• positive = lateral hip or groin pain with adduction

Question 11

Describe Patrick test/FABER

Answer 11

• Positive with anterior pain or discomfort = hip instability
• Positive SI area pain or discomfort = SI pain
• positive decreased ROM = hip OA
• patient supine with hip in external rotation and abduction with crossing of foot on opposite thigh and push thigh towards table

Question 12

FABER Test

Answer 12

• patient supine with test leg foot just proximal to patella opposite knee
• stabilize opposite ASIS and passively lower test leg into abduction towards the table
• Negative = test leg to table or parallel with opposite leg & no pain
• Positive = test leg remaining above opposite leg or pain

Question 13

Arthritis cluster

Answer 13

• squatting aggravates symptoms
• pain with active hip flexion (lateral hip/groin)
• pain with active hip extension (lateral hip/groin)
• Scour tests with adduction causes lateral hip pain or groin pain
• Passive internal rotation ROM < or equal to 25 degrees

Question 14

Trendelenburg test

Answer 14

• standing on one leg and opposite hip drops
• glute medius weakness is suspected or unstable hip

Question 15

Special tests for labral tear

Answer 15

• IR, flexion, & axial compression maneuver
• Flexion, adduction, & IR test/FAIR
• Posterior labral tear test

Question 16

Describe IR, flexion, & axial compression maneuver test

Answer 16

• patient supine
• flex and IR the patient’s hip then apply axial compression
• positive = provocation of pain for suspected labral tear

Question 17

Describe flexion, adduction, & IR test/FAIR

Answer 17

• patient is sidelying
• stabilize pelvis while moving patient’s hip into 50-100 degrees of flexion with adduction & IR
• positive = presence of a click for possible labral tear
• reproduction of sciatica = piriformis syndrome

Question 18

Describe posterior labral tear test

Answer 18

• patient is supine
• place leg into full flexion, IR, and adduction
• move patient’s leg into extension, ER, and abduction
• positive = pain or reproduction of symptoms with/without click, groin pain or patient apprehension for possible labral tear, anterior hip instability, or posterior inferior impingement

Question 19

Describe test for Femoroactetabular impingement

Answer 19

• FADIR
• supine with leg in full flexion, ER, and abduction
• move leg into extension with IR and adduction
• positive = pain or reproduction of symptoms with/without click for possible anterior superior impingement or OA

Question 20

Describe the long stride walking test

Answer 20

• Long stride walking
• patient is asked to walk with long strides
• pain at terminal extension
• positive = pain relieves when walking with hip abducted

Question 21

Describe the ischiofemoral impingement test

Answer 21

• patient is sidelying with affected leg on top
• passively extend hip

Question 22

Describe the patellar pubic percussion test

Answer 22

• test for a fracture
• patient is supine
• PT taps one patella at a time while auscultating pubic synthesis with a stethoscope
• positive = diminution of percussion noted on affected side

Question 23

Describe the Thomas test

Answer 23

• muscle length test/provocation test for labral tear
• patient supine at edge of table
• have patient flex both knees & hips pulling them to chest
• lower one leg into extension

Question 24

Describe Ely test

Answer 24

• patient is prone with passive knee flexion

Question 25

Describe Ober test

Answer 25

• patient is sidelying
• flex knee to 90 degrees and abduction and extend hip until it’s in line with trunk
• slowly allow hip to adduct while maintaining pelvis in neutral

Question 26

Describe how to perform true leg length

Answer 26

• supine set pelvis and legs about 15-20 cm (5-8 inches) apart & parallel
• use tape measure from ASIS to medial malleolus or ASIS to lateral malleolus
• normal = slight difference of 1 to 1 1/2 cm but can cause symptoms
• Positive = different levels indicate asymmetry