Leg Length Discrepancy Test

Other Names

• Leg Length Discrepancy Test
• Direct tape measurement method

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Purpose

Demonstration of the ASIS to medial malleolus technique

• Measure limb length to compare both legs

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Description

• Measure from Pubic symphysis to medial malleolus
  • Apparent Method
• Measure from ASIS to medial malleolus
  • True Method
  • Less accurate orientation due to crossing over patella
• Measure ASIS to Lateral Malleolus
  • Most accurate orientation due to straight inferiorly
• Xiphoid process over umbilicus down to malleolus
  • Least accurate due to crossing over multiple joint lines
• Compare measurements bilaterally
• Positive test
  • Clinically significant > 2cm shortening of affected side comparatively (true or pseudo LLD)

Block Method

• Observe iliac crest & palpate symmetry
  • Insert a block or book under affected side
  • Continue until bilateral iliac crests are symmetrical in height
  • Positive test
    • Block or book elevation difference of affected limb to make iliac crests symmetrical
  • Relies on 3 objective findings to signify leg length discrepancy
    • Upper lateral thigh will protrude when standing
    • Scoliosis will be apparent
    • Examiner’s hands on patient’s iliac crests will rest at different heights

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Pathology

• Leg Length Discrepancy

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Evidence

• Unknown

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See Also

• Hip Pain Main
• Physical Exam Hip

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