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Examination of Hip
- introduction, permission, exposure
- anterior superior iliac spines at same level
Look
- roll to one side
- buttock
- posterior thigh
- scars
- sinuses
- soft tissue swellings
- muscle wasting
- ankles
- bony alignment
- obvious difference in leg length
- patella and foot
- angle between thigh and bed
Measure
- True leg length
- Apparent leg length
- xiphisternum to medial malleolus
- Compare position of knees
- ASIS to greater trochanter
Feel
- tenderness
- palpate
- over greater trochanter
- anterior joint line
Move
- Thomas' Test
- hand in hollow of lumbar spine
- flex hip of unaffected side until spine straightens
- does affected side lift off bed
- flex hip and knee of affected side
- normal 130º
- Abduction / adduction
- left forearm between ASISs
- ankle with other arm and fabduct / adduct
- normal range abduction 45º adduction 30º
- Rotation
- normal range 45º each way
- Abnormal movements
Stand
- anteriorly
- laterally
- pelvic tilt
- increased lumbar lordosis
- posteriorly
- scoliosis
- gluteal wasting
- Trendelenburg Test
- patient stands on one leg
- opposite hip rises = normal = negative test
- opposite hip falls = abnormal = positive test
- Gait
Completion
- patient comfortable
- present findings
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