Hip Examination

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Look

From the end of the bed, check for scars and if there is an obvious flexion deformity, and look for symmetry.

  • In fractured head of femur, one leg may be shortened and rotated externally.

Any obvious leg length discrepancy may be seen and can be checked for using a tape measure.

  1. Measurement should be taken from a fixed point
  2. Such as the anterior superior iliac crest to the medial malleolus
  3. Both sides are compared
  4. A difference means a real leg length discrepancy.

Feel

Palpate the greater trochanter for tenderness

Move

Perform the following movements:

  • Full flexion of the hip
  • Full internal and external rotation

Thomas test.

  • Full flexion on one hip.
  • If bad, the opposite leg will rise up.

Trendelenburg’s test.

  • Stand on one leg, knee flexed. Do both legs. In a normal test, the hip will drop on the bent side.

Finally, ask Patient to walk.

  • Look for waddling gait – sign of hip pain, or proximal muscle weakness