Trendelenburg Test
Other Names
- Trendelenburg's Sign
- Trendelenburg Gait
- Modified Trendelenburg Test
Purpose
- Evaluate the strength of the hip abductors, specifically Gluteus Medius and Gluteus Minimus
Description of Test
- The patient is standing on their affected leg for approximately 30 seconds without leaning
- They can stabilize themselves on the examination table or examiner if needed
- Examiner examines patient to observe for stability or level of pelvis during single leg stance
- Comparison should be made to the unaffected limb
- Positive test
- Unilateral weight bearing the pelvis drops toward the unsupported side
Trendelenburg Gait
- Essentially identical to Trendelenburg test, except you observe gait instead of single leg stance
- Positive test
- Inability to maintain balance or pelvic stability
- Lateral tilt of the trunk away from the affected hip
Pathology
- Weakness of gluteus medius
- Greater Trochanteric Pain Syndrome
- Hip instability and subluxation
- Hip osteoarthritis
- Initially post Total Hip Replacement
- Superior Gluteal Nerve Palsy
- Lower back pain
- Legg-Calvé-Perthes Disease
- Congenital hip dislocation
Evidence
Gluteus Medius Tear
- Ortiz-Declet et al looking at Gluteus Medius Tears[3]
- Sensitivity: 31%
- Specificity: 100%
- PPV: 100%
- NPV: 61%
- Diagnostic Accuracy: 67%
Greater Trochanteric Pain Syndrome
- Kinsella et al: Systematic Review, Meta Analysis[4]
- Sensitivity: 35%
- Specificity: 99%
- LR+: 53.44
- LR-: 0.65
- Diagnostic OR: 82.08
See Also
References
- ↑ Wong, Stephanie E., Charles J. Cogan, and Alan L. Zhang. "Physical examination of the hip: assessment of femoroacetabular impingement, labral pathology, and microinstability." Current Reviews in Musculoskeletal Medicine 15.2 (2022): 38-52.
- ↑ Reiman, Michael P., Richard C. Mather, and Chad E. Cook. "Physical examination tests for hip dysfunction and injury." British journal of sports medicine 49.6 (2015): 357-361.
- ↑ Ortiz-Declet, Victor, et al. "Diagnostic accuracy of a new clinical test (resisted internal rotation) for detection of gluteus medius tears." Journal of Hip Preservation Surgery 6.4 (2019): 398-405.
- ↑ Kinsella, Rita, et al. "Diagnostic accuracy of clinical tests for assessing greater trochanteric pain syndrome: a systematic review with meta-analysis." Journal of Orthopaedic & Sports Physical Therapy 54.1 (2024): 26-49.