We need you! See something you could improve? Make an edit and help improve WikSM for everyone.
Physical Exam Hip
From WikiSM
Contents
Introduction
- Follows the IP-PASS examination methodology
- Inspection
- Palpation
- Passive Range of Motion
- Active Range of Motion
- Strength & Neurovascular
- Special Tests
Inspection
- Skin
- Color: erythema, ecchymosis, white, black
- Trophic changes (altered hair growth, sweat production)
- Scars
- Swelling
- Muscle tone: atrophy, hypertrophy
- Deformity: asymmetry, rotation, amputation
- Areas of emphasis for back exam
- Resting position of hip/ leg (internal/ external rotation)
- Leg length discrepency
Palpation
- Palpate for
- Effusion
- Clicking
- Snapping
- Crepitus
- Tenderness
- Temperature
- Masses
- Areas of Emphasis
- Greater Trochanter
- Piriformis muscle
- Ischial Tuberosity (if appropriate)
- Pubic symphysis (if appropriate)
- Iliopsoas bursa
Range of Motion
- Hip
- Flexion: 120
- Extension: 45
- Abduction: 40
- Adduction: 25
- Internal Rotation: 45
- External Rotation: 45
Strength
- Back
- Extension: Erector Spinae Muscles, Multifidus
- Lateral Flexion (sidebending): Erector Spinae Muscles, Quadratus Lumborum
- Rotation: Multifidus
- Flexion: Rectus Abdominis, Internal Obliques, External Obliques
- Hip
- Hip Flexion (L2, L3): Iliopsoas
- Hip Adduction (L2, L3): Gracilis, Obturator Externus, Adductor Brevis, Adductor Longus and Adductor Magnus
- Hip Extension (L5): Gluteus Maximus, Biceps Femoris, Semitendinosus, Semimembranosus, Adductor Magnus
- Hip Abduction (L5): Gluteus Medius, Gluteus Minimus, Tensor Fasciae Latae
- Knee
- Knee Extension (L3, L4): Rectus Femoris, Vastus Lateralis, Vastus Medialis, Vastus Intermedius
- Knee Flexion: Biceps Femoris, Semitendinosus, Semimembranosus, Gracilis, Sartorius, Gastrocnemius, Popliteus
- Ankle
- Dorsiflexion (L4, L5): Tibialis Anterior
- Plantarflexion (S1): Gastrocnemius, Soleus, Peroneal Muscles
- Eversion (S1): Peroneal Muscles
- Inversion (L5): Tibialis Posterior
- Foot
- Toe Dorsiflexion (L5): Extensor Hallucis Longus, Extensor Digitorum Longus
- Toe Plantarflexion (S2): Flexor Hallucis Longus, Flexor Digitorum Longus
Neurovascular
- Sensory Nerves /Dermatomes
- L1: Iliac crest, groin
- L2, L3: Anterior and inner thigh
- L4: Lateral thigh, anterior knee, medial leg
- L5: Lateral leg, dorsal foot
- S1: Posterior Leg
- S2: Plantar foot
- S3, S4: Perianal
- Reflexes
- Commonly Used
- Patellar (L3, L4)
- Achilles (S1, S2)
- Uncommonly Used
- Medial Hamstring (L5, S1)
- Lateral Hamstring (S1, S2)
- Posterior Tibial (L4, L5)
- Cremasteric (L1, L2)
- Anal wink/ bulbocavernous (S2)
- Commonly Used
- Myotomes
- L2: Hip Adduction, Hip Flexion
- L3: Knee Extension, Hip Adduction, Hip Flexion
- L4: Knee Extension, Dorsiflexion
- L5: Hip Abduction, Hip Extension, Toe Dorsiflexion, Foot Inversion, Dorsiflexion
- S1 Foot Version, Plantarflexion
- S2: Toe Plantar Flexion
- S3: Bowel, bladder function
- S4: Bowel, bladder function
- Vascular
Special Tests
- General Hip Joint Pathology (OA, Labrum, FAI, AVN, etC)
- FABER Test
- FADIR Test
- Stinchfield Test
- Flexion Internal Rotation Test
- IROP Test (Internal rotation over pressure)
- Log Roll Test
- Axial Distraction Test
- Scour Test
- Hamstring Strain
- Proximal Hamstring Tendinopathy
- Adductor Tendonitis
- Avascular Necrosis of the Hip
- Hip Osteoarthritis
- Femoroacetabular Impingement
- Piriformis Syndrome
- Hip Flexor Tendonitis (including Tightness, Contracture)
- Rectus Femoris Contracture or Tightness
- Hip Extensor Tightness or Contracture
- Greater Trochanteric Pain Syndrome
- Ischial Bursitis
- Acetabular Labrum Tear
- Meralgia Paresthetica
- Snapping Hip Syndrome
- Femoral Neck Stress Fracture
See Also
External
- Sports Medicine Review Hip Pain: https://www.sportsmedreview.com/by-joint/hip/
- https://www.sportsmedreview.com/blog/special-tests-for-physical-exam-of-the-hip/
Created by:
John Kiel on 20 August 2020 16:06:06
Authors:
Last edited:
9 November 2022 15:36:27
Categories: