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Examination of the hip
This document discusses the examination of the hip joint. It outlines the traditional steps in examining the hip, including taking a history, inspecting for deformities, palpating for tenderness, and measuring range of motion. Special tests are also described, such as the Trendelenberg test to assess abduction weakness. A variety of hip conditions can be evaluated through clinical examination, including developmental dysplasia of the hip, Perthes disease, tuberculosis, and traumatic injuries. Proper examination of gait, identification of fixed deformities, and use of special tests remains an important orthopedic skill.
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Examination of the hip
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- 3. IN ORTHOPAEDIC TRAINING •The skill in eliciting/demonstrating abnormalities of the hip remains as the mainstay in assessment of orthopaedic trainee
- 4. CLINICAL EXAMINATION OFHIP USEFUL IN • DDH • NEONATAL SEPTIC ARTHRITIS • TRANSIENT SYNOVITIS • PERTHES DISEASE • SUFE • TUBERCULOSIS • OSTEOAARTHROSIS • TRAUMATIC CONDITIONS
- 5. EXAMINATION OF HIP Traditionalsteps • History of symptoms • Relevant general examination • Gait • Inspection • Palpation • Looking for Fixed deformities • Movements • Measurements • Special tests • Tests for instability
- 6. HISTORY • Pain • Feltin groin, thigh or knee • Limping • Also an early symptom
- 7. RELEVANT GENERAL EXAMINATION • Forthe diagnosis & • Its management
- 8. RELEVANT GENERAL EXAMINATION For thediagnosis
- 9. RELEVANT GENERAL EXAMINATION Not relevantfor diagnosis
- 10. RELEVANT GENERAL EXAMINATION For hismanagement
- 11. GAIT • Simplest ofall definitions “mode of walking”
- 12. GAIT • Normal gaitis rhythmical bipedal biphasic walking in which the lumbar spine, hip and legs move in unison
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- 14. LIMPING • Limping isthe most common abnormality • Can be defined as any abnormality of normal rhythmic biphasic walking
- 15. GAIT • Types – Painlesslimping – Painful limping – Stiff hip – High stepping – Crutch gait
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- 17. CRUTCH WALKING – Twopoint – Three point – Swing to – Swing through
- 18. CRUTCH GAIT Three pointgait Swing through gait Swing to gait
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- 22. PALPATION • TENDERNESS – ANTERIOR –Posterior & lateral – Bitrochanteric compression
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- 25. FIXED DEFORMITIES • Fixedflexion deformity Concealed during walking by increase in lumbar lordosis
- 26. FFD DEMONSTRATION HUGH OWENTHOMAS’S TEST
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- 28. FIXED ABDUCTION & ADDUCTIONDEFORMITY • Pelvic tilt indicated by ASIS at different level
- 29. FIXED ABDUCTION & ADDUCTIONDEFORMITY DN
- 30. FIXED ABDUCTION & ADDUCTIONDEFORMITY N D
- 31. FIXED ABDUCTION & ADDUCTIONDEFORMITY N D
- 32. FIXED ABDUCTION & ADDUCTIONDEFORMITY N D
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- 41. MEASUREMENTS • Apparent shortening • Dueto pelvic tilt or FFD • Measured from xiphisternum to medial malleolus
- 42. MEASUREMENTS True shortening Square thepelvis ASIS MEDIAL JOINT LINE KNEE MEDIAL MALLEOLUS
- 43. MEASUREMENTS True shortening- SupraTrochanteric Bryants triangle Nelatons line
- 44. MEASUREMENTS Supra trochanteric • CoxaVara • Perthes • SCFE • Malunited basal # NOF • Congenital Coxa Vara • Arthritis • Dislocation Infra trochanteric – Malunion – Fracture femur & tibia – Growth arrest from polio – Trauma and infective sequale True shortening
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- 46. SPECIAL TESTS • TrendelebergTest • Fulcrum socket • Lever length of head and neck • Force Gluteus Medius
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- 48. SPECIAL TESTS Trendelenberg test Normalhip Positive test
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- 50. SPECIAL TESTS • Ortolanitest • Barlow’s test • Patrick test • Febere sign • Duchnne sign
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