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EXAMINATION OF
HIP
HISTORY
1. PAIN
2. SWELLING
3. DEFORMITY
4. RESTRICTION OF
MOVEMENTS
Injury ,
pathology
AGE
• BIRTH – 5 YRS - CONGENITAL DISLOCATION
• 5 – 10 YRS - PERTHE ‘S DISEASE
• 10 – 15 YRS – ADOLESCENT COXA VARA
• ABOVE 40 YRS – OSTEOARTHRITIS
GENERAL EXAMINATION
1. Fever
2. Lymph nodes
EXAMINATION
of hip
1. Inspection
2. Palpation
3. Movement
4. Measurement
INSPECTION
Neck of femur
fracture
Posterior
dislocation
Trendelenburg gait is
positive
• Problem with abductors (poliomyelitis ,
motor neuron diesease )
• Problems with fulcrum ( dislocation ,
fracture of neck , perthes diesease )
Trendelenburg test
Hip deformities
1. Fixed abduction
2. Fixed adduction
3. Fixed flexion ( thomas test )
4. Fixed medial rotation
5. Fixed lateral rotation
Tuberculosis of hip
• Stage 1 – synovitis
 attitude - flexion , abduction , external
rotation
• Stage 2 – arthritis
 attitide - flexion , adduction , internal rotation
• Stage 3 – bone erosion
 attitude – same as stage 2
• Muscular wasting
• Skin ( swelling , scar , cold abscess )
EXAMINATION
of hip
1. Inspection
2. Palpation
3. Movement
4. Measurement
PALPATION
Fractures and dislocations
• Palpate for head of femur position (
posterior , groin , perineum )
• Femoral artery ( not felt in posterior
dislocation )
• Tenderness over the fracture site
Pathology
• Tenderness over greater trochanter ( bursitis ,
tendinitis )
• Palpation of joint ( arthritis )
• FABER TEST
anterior pain – femoro acetabular joint
posterior pain – sacro iliac joint
• FADIR TEST ( FEMORO ACETABULAR IMPINGEMENT )
• Femoral artery (congenital dislocation of hip)
• Lymph nodes
• Rectal examination :
done in cases of central
dislocation .
Congenital dislocation of hip
• Barlow test
• Ortolani test
• Telescopic test
EXAMINATION
of hip
1. Inspection
2. Palpation
3. Movement
4. Measurement
Movements
• Flexion – 120˚
• Extension – 15˚
• Abduction – 40˚
• Adduction – 30˚
• Internal rotation – 30˚
• External rotation – 45˚
EXAMINATION
of hip
1. Inspection
2. Palpation
3. Movement
4. Measurement
Measurements
1.Length of the limb :
True length – length from ASIS to medial
malleolus
Apparent length – length from
xiphisternum to medial malleolus
2. Bryants triangle -
3. Nelaton line -
4. Schoemaker’s line :
5. CHIENE’S LINE :
Line joining the greater
trochanters of femur and line joining
the ASIS are parallel .
6. Morris bitrochanteric test :
Distance between greater
trochanter and pubic symphysis is
measured and compared with the
other side .
7. Measurement of muscle girth

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Examination of hip