The document provides an overview of the clinical examination of the hip joint, including: 1) Inspection involves observing the patient standing, walking, and supine to identify any deformities, swelling, muscle wasting, or limb length inequality. Walking may reveal an antalgic or Trendelenburg gait. 2) Palpation feels for tenderness along the anterior joint line or adductor muscles, as well as any swelling. 3) Active range of motion tests flexion, abduction, adduction, and internal rotation to identify painful movements. 4) Special tests like the Patrick test/FABER test and Thomas test help diagnose specific hip conditions. Measurements of limb length and muscle

1. Clinical Examination of
Hip Joint
Dr Ritasman Baisya
NIMS

2. Contents
• Anatomy – brief
• Clinical Examination

3. Hip joint

4. Muscles around hip joint

5. Iliopsoas

6. Adductors

7. Rotators

9. Hip joint examination
 Inspection:
• Standing
• Walking
• Supine
 Palpation
 Movements
 Measurements
 Special tests

10. INSPECTION- standing
EXPOSURE
• Standing:
– Front: Pelvic tilt, rotational deformity
– Side: Lordosis
– Behind: Pelvic tilt, scoliosis, muscle wasting
• Walking: Gait
• Supine: Skin, swelling, deformity, limb length inequality

11. INSPECTION- standing

12. Antalgic gait
• Painful hip
• Shortens stance phase
on affected hip
• Leaning over affected
site to avoid painful
contraction of hip
abductor
Inspection – walking

13. Trendelenburg gait
• Indicates weakness of
abductor in affected site
• During stance phase on
affected site ,
contralateral pelvis dips
down
• Body leans to unaffected
site
• If both side – waddling
gait

14. Inspection – supine
• Skin changes
• Swelling – iliopectineal bursa
swelling at medial groin
extension of Baker cyst
• Deformity – fixed flexion , external
rotation , abduction

15. Inspection – supine
• Leg length inequality-
true leg length
apparent leg length
• Attitude – most comfortable in flexion ,
external rotation , abduction

16. PALPATION
• Temperature
• Pulsation
• Tenderness: anterior joint line, adductor enthesopathy
• Swelling: Bursitis Vs Hernia
• Lateral position: GT (Bursitis, abductor enthesopathy)
Ischial tuberosity

17. Anterior joint line
• Tenderness in anterior
joint line indicates hip
synovitis or
iliopectineal bursitis

18. Resisted active adduction and palpation of adductor
enthesopathy Palpation of ischial tuberosity and
ischio-gluteal bursitis

19. MOVEMENTS

20. Hip flexion - with knee flexed to relax hamstring

21. Abduction ( = 45 )

22. Hip adduction ( range – 30)

23. Internal rotation = earliest and constantly affected movement in most hip disease

25. MEASUREMENTS
• Muscle bulk
• Limb length:
– Apparent
– True

26. SPECIAL TESTS
• Patrick Test / FABER Test
• Thomas test
• Trendelenburg test:
– Hip disease, U/L L-5 root lesion, weakness
• SLRT

27. FABER test