Hip Examination Checklist

Question 1

What are the initial steps in a hip examination?

Answer 1

Infection control, introduce self, identify patient, explanation, consent, check for discomfort, adequately expose (underwear below waist).

Question 2

What should be inspected during a hip examination?
standing

Answer 2

Standing: quadriceps, hamstrings, gluteal muscles;.

Question 3

What should be inspected during a hip examination?
Gait

Answer 3

Gait: pace, symmetry, walking aids, antalgic, stiff, Trendelenburg, other gross abnormalities;

Question 4

What should be inspected during a hip examination?
Lying

Answer 4

attitude of limb, erythema, skin changes, bruising, scars, swelling over greater trochanter.

Question 5

What are the normal ranges for hip movements?

Answer 5

Flexion: active and passive, 100-130 degrees; Internal rotation: passive, 75 degrees; External rotation: passive, 40 degrees; Abduction: passive, 45 degrees; Adduction: passive, 75 degrees.

Question 6

What areas should be palpated during a hip examination?

Answer 6

Greater trochanter and groin (midline and medially).

Question 7

Pain in greater trochanter

Answer 7

Bursitis

Question 8

Pain in groin

Answer 8

Pubic rami frature

Question 9

What are the normal ranges for hip movements?

Answer 9

Flexion: , 100-130 degrees;
Internal rotation: , 75 degrees
External rotation: 40 degrees
Abduction:45 degrees;
Adduction: 75 degrees.

Question 10

What special tests are performed during a hip examination?

Answer 10

Trendelenburg test for abductor power, limb length (true and apparent), Thomas’ test to identify a fixed flexion deformity.

Question 11

What is the Trendelenburg test used for?

Answer 11

It assesses hip abductor muscle strength (gluteus medius, gluteus minimus, and tensor fascia lata).

Positive test: If the abductor muscles are weak, the standing leg will move into adduction, and the pelvis moves down on the unsupported side.

Question 12

How is true limb length measured?

Answer 12

With the patient supine, measure from the ASIS to the tip of the medial malleolus.

Question 13

How is apparent limb length measured?

Answer 13

With the patient supine, measure from the xiphisternum to the medial malleolus.

Question 14

What does the Thomas’ test identify?

Answer 14

It identifies a fixed flexion deformity (incomplete extension) at the hip.

Positive test: A fixed flexion deformity is present when the ipsilateral thigh lifts off the couch.

Question 15

What should be done at the closure of a hip examination?

Answer 15

Explanation and appropriate documentation of findings, thank patient, infection control.