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Hip physical exam Flashcards

(51 cards)

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1
Q

what are some musculoskeletal differential diagnosis?

A

lumbar exam
lumbar repeated movements (does a direction of preference emerge? centralization of symptoms?)
SI exam
knee exam

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2
Q

what are we looking for in our observation/postural examination?

A

visible swelling?
skin color
symmetrical WB?
assess balance (one legged standing)
LE alignment (compensated anteversion/retroversion, leg length discrepancy (coxa valga/vara))

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3
Q

what is seen with compensated anteversion?

A

toed in

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4
Q

what is seen with compensated retroversion?

A

toed out

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5
Q

what is the normal degrees of version?

A

10-20º forward (anteversion)

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6
Q

what is increased femoral anteversion?

A

> 20º

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7
Q

what is femoral retroversion?

A

<10º

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8
Q

what is femoral version defined as?

A

the angular difference between axis of femoral neck and transcondylar axis of the knee

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9
Q

what is the normal angle of inclination?

A

126-139º

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10
Q

what is considered coxa valga?

A

> 140º

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11
Q

what is considered coxa vara?

A

<125º

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12
Q

what should we be looking for in gait/ambulation?

A

antalgic?
trendelenbrug?

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13
Q

what is a maneuver to measure leg length discrepancy true vs apparent?

A

weber-barstow maneuver
starting position is supine knees bent, then patient lifts hips off bed, PT compares height of medial malleoli with the legs extended

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14
Q

what are ways to measure leg length discrepancy?

A

weber-barstow maneuver
prone knee flexion test for tibial shortening
measure from umbilicus to great toe on each leg

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15
Q

what movements do we take goniometric measurements of?

A

flexion, extension, abduction, adduction, ER, IR

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16
Q

what are normal values for hip flexion?

A

0-120º

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17
Q

what are normal values for hip extension?

A

0-30º

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18
Q

what are normal values for hip abduction?

A

0-45º

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19
Q

what are normal values for hip adduction?

A

0-30º

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20
Q

what are normal values for hip ER?

A

0-45º

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21
Q

what are normal values for hip IR?

22
Q

what is the capsular pattern at the hip?

Study These Flashcards
A

limitation in flexion, abduction and IR
max loss IR, moderate loss flexion, and moderate loss abduction
minimal loss of extension = greater functional limitation than the same loss of flexion

23
Q

what is a positive scour test/ quadrant test?

Study These Flashcards
A

pain, grinding, catching or crepitation in the hip- concern for intra-articular pathology (OA, labral pathology, osteochondral defect, or osteonecrosis)

24
Q

how is the scour test/quadrant test perfromed?

Study These Flashcards
A

patient supine. PT flex to 90º and IR/add, then flex ER/add

25
what is the anterior labral tear test (FADIR) for?
the examination of the femoracetabular impingement syndrome or an anterior labral tear
26
how is the anterior labral tear test performed?
patient supine, flexion, adduction, internal rotation
27
what is important to remember with FABER test/Patrick's test/Figure-four?
compare bilaterally for ROM and pain (with overpressure) can be used as a comparable sign
28
if a patient has decreased ROM with FABER test what is it indicative of?
hypomobile SI or hip joint, or tight adductors/hip flexors
29
if a patient reports pain with FABER test what is it indicative of?
PSIS/buttocks- SI/lumbar spine pathology GT/thigh- intra-articular hip joint pathology knee- meniscal pathology
30
how is FABER test performed?
patient supine, flexion, abduction, ER
31
how many zones are there in the flexion-adduction test?
3
32
in a normal population what zone should a patient be able to adduct to in the flexion-adduction test?
1
33
if a patient can only get to zone 2 or 3 they may have pathologic changes (limitation secondary to pain, apprehension, or limited end rage) what could it be indicative of?
children: legg-calve-perthes disease and SCFE adults: sinister pathology like fracture, cancer
34
what 3 muscles are being tested in the thomas test (3 muscle kendall test)?
iliopsoas: hip flex, and hip ER rectus femoris: hip flex, and knee extension TFL/ITB: hip flex, and hip abduction
35
during ober test what is indicative of a tight ITB?
< 10º hip add
36
for craig's test what defines femoral anteversion?
more than 15º
37
for craig's test what defines femoral retroversion?
less than 8º
38
what movements are assessed with MMT?
flexion/extension/abduction/adduction/ IR/ER of hip flexion and extension of knee
39
what does a positive trendelenburg test indicate?
organic hip abductor weakness hip compression load intolerance (hip OA or labral tear) trohchanteric bursitis/ iliotibial band syndrome S1 myotome involvement
40
what does the patellar-pubic percussion test test for?
fracture of hip
41
how is the patellar-pubic percussion test performed?
tap patella or use tuning fork- asses qualitatively the sound bilaterally
42
what is a positive patellar-pubic percussion test?
diminished percussion note on side of pain
43
what is a negative patellar-pubic percussion test?
no difference bilaterally
44
what is the FAIR test?
60º hip flexion 90º knee flexion hip add to table passive IR of hip to end range
45
what is a positive FAIR test?
pain at intersection of sciatic nerve and piriformis
46
what is the open pack position of the hip?
30º flex, 30º abd, slight (5º) ER
47
what is the closed pack position of the hip?
max extension max IR
48
what joint play/accessory motion are we testing at the hip?
acetabulofemoral long axis distraction acetabulofemoral caudal glide- hip at 90º acetabulofemoral lateral distraction- hip at 90º acetabulofemoral anterior glide femur acetabulofemoral anterior glide femur in prone FABER position acetabulofemoral inferomedial glide
49
what can we palpate on the hip in the anterior/lateral aspect?
ASIS/AIIS iliac crest greater trochanter inguinal ligament muscles: flexors/adductors/abductors
50
what can we palpate on the hip in the posterior aspect?
ischial tuberosities/PSIS
51
what are some activity limitation and participation restriction measures we can test?
6 minute walk test self-paced walk test (20-m) stair measure (9 stairs) timed-up and go test (3-m)

musculo (19 decks)

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