week 2 - hip

Question 1

What are some specific subjective questions for the hip?

Answer 1

aggs/eases -> squatting, walking, side lying, stairs, putting socks on
locking/catching
crepitus
neurological symptoms
lumbar symptoms

Question 2

What could locking/ catching indicate in the hip?

Answer 2

FAI or labral injury

Question 3

What is crepitus?

Answer 3

a grating sound produced by friction between bone and cartilage or the fractured parts of bone

Question 4

What can crepitus in the hip indicate?

Answer 4

It can indicate degeneration in the joint or some roughening of the cartilage

Question 5

What are the general red flags?

Answer 5

weight loss
malaise
unremitting pain
night pain
previous history of cancer
fever
redness
heat
swelling
underweight
eating disorder
history of stress fractures
DVT
Trauma

Question 6

What are some hip specific red flags?

Answer 6

lumps/bumps in groin
testicular swelling

Question 7

Which accessory movements are available at the hip?

Answer 7

AP
PA
Longitudinal caudad
Lateral distraction

Question 8

What is the modified Thomas test used for?

Answer 8

It tests for tightness in the hip
It can be used to differentiate between tightness in hip flexors, rectus femoris and lateral structures

Question 9

What does the Obers test test?

Answer 9

initially thought to test the length of the ITB
Some evidence now to suggest that it tests the glute med and min more than ITB

Question 10

What is a Trendelenburg test?

Answer 10

single leg stance assessment

Question 11

What is a positive for Trendelenburg?

Answer 11

Drop on opposite side of pelvis, reproduction of pain

Question 12

What does a positive Trendelenburg test indicate?

Answer 12

Weakness in hip abductors if positive

Question 13

Name some common signs and symptoms of hip osteoarthritis

Answer 13

pain commonly in the groin, may radiate to buttock or knee
clicking/crepitus
more common in older popluation
tend to have pain on deep flexion activities - putting socks on, squatting
aggravated by cold/wet weather
reduced range of motion (capsular patter)
altered gait pattern

Question 14

Name some common signs and symptoms of gluteal tendinopathy

Answer 14

lateral hip pain
normally associated with an overload
pain on walking, standing on one leg
pain on side lying
pain on palpation of glute tendons (around greater trochanter)
Pain on resisted hip abduction
pain on stretch of glutes - Obers test, hip adduction
Positive Trendelenburg

Question 15

What is a capsular pattern?

Answer 15

The characterised ranges of restricted movement exhibited by a joint
Normally relates to a joint specific condition

Question 16

What is the hip capsular pattern?

Answer 16

flexion
medial rotation
Abduction

Question 17

How do you carry out the modified Thomas test?

Answer 17

Patient sits on the edge of the bed, holding one knee to their chest
the hip being tested is the side that is not being held
maintaining the position of the flexed hip, the patient lies down

Question 18

Which structure is the problem if the patient extends their knee during the modified Thomas test?

Answer 18

Rectus Femoris

Question 19

Which structure is the problem if the patient abducts their hip during the modified Thomas test?

Answer 19

lateral structures

Question 20

Which structure is the problem if the patients tested side leg lifts off of the plinth during the modified Thomas test?

Answer 20

hip flexors

Question 21

How do you carry out the Ober’s test?

Answer 21

lay on side
testing the uppermost side, abduct hip, fix pelvis then lower limb back down