Performed in standing, supine and lateral positions
Inspection
- lumbar lordosis
- attitude of limb
- levels of ASIS, patellae, malleoli
- swelling--gluteal region ,Scarpa’s triangle, trochanteric region
- scars, sinuses
- skin over the joint
- muscle wasting
Palpation
- temperature
- tenderness-anterior joint line, posterior joint line
- trochanteric palpation
- level
- trochanteric tenderness- superficial /deep / transtrochanteric
- trochanteric surface--thickening / irregularity
- palpable swelling
- hard : femoral head, bony neoplasm
- firm : soft tissue neoplasm
- soft : cold abscess
- Vascular sign of Narath
Movements
- Thomas’ test for flexion deformity of the hip
- determination of abduction / adduction deformity
- Flexion
- Extension
- Abduction
- Adduction
- External & internal rotation in hip extension (prone) & with hip flexed 90 degrees
- active/passive
- lag/deformity/arc
- compare with opposite side
- Differential rotation
- Knee to axilla sign
MEASUREMENTS
- apparent length
- true length-
supratrochanteric
- Bryant’s triangle
- Nelaton’s line
- Shoemaker’s line
infratrochanteric segmental lengths- femur, tibia
- thigh & calf girth
- Gluteal wasting
- Galeazzi test
Special tests
- Trendelenburg test
- Trendelenburg sign
- telescopy
Other tests
- Gait
- Function-ambulation distance, walking, sitting, squatting,stairs
- Other joints-Hip, SI joint , knee joint
- lymph nodes (inguinal,external iliac group)
- Per abdomen examination
- Per rectal examination
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