Consider asking which side is the patient's kicking foot if they are a sportsperson
Check for general lower leg alignment, scars or sinuses, asymmetry between sides
Indicative of pain
Patient cannot keep the opposite hip 'up' when standing on the affected leg. Caused by weakness of the standing leg's gluteus medius.
e.g., shortened and externally rotated (unopposed iliopsoas) in #NOF
A leg may look short without actually being short e.g. A person with a fixed adduction of the right hip had to hitch up his pelvis in order to uncross his legs making the right leg appear shorter
Measure from umbilicus to medial malleolus
Measure from ASIS on same side to medial malleolus
Use back of hands and compare sides
Normal range: 30 deg. Cross one limb over other – observe the point when the pelvis starts to tilt
Normal range: 45 deg. Ensure ASISs are level, fix pelvis by stabilising opposite iliac crest
Normal range: 130 deg
Normal range: 10 deg. Performed in prone position
Normal range: 40 deg. Test in neutral and 90 deg flexion. Rotate internally watching patellae
Normal range: 50 deg. Test in neutral and 90 deg flexion. Rotate externally watching patellae
Flexion, abduction, external rotation
Flexion, adduction, internal rotation (anterior impingement/quadrant test)
Examiner places fist between knees at 60 degrees hip and knee flexion and patient adducts bilaterally against the fist (suggestive of osteitis pubis if positive)
Patient stands unassisted on each leg in turn and lifts the other leg by bending the knee. Normally the weight-bearing hip is held stable by the abductors and the pelvis rises on the unsupported side; if the hip is unstable or very painful the pelvis drops on the unsupported side. Positive Trendelenburg seen with hip subluxation/dislocation, hip abductor weakness, shortening of femoral neck
Used to unmask fixed flexion deformity hidden by excessive lumbar lordosis. Both hips are flexed simultaneously to their limit and holding the non-test knee in this position the test limb is lowered gently. If there is a flexion deformity at the hip the knee will not rest on the couch
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