1

Evaluationof the

Hip

HISTORY

Remember the questions from

lecture #2?

PALPATION

Let’s break the body up into 4 areasMedialAnteriorLateralPosterior

Use Bony Landmarks to Identify StructuresStart proximally and palpate distally

2

MEDIALPubic BoneGracilisAdductor LongusAdductor MagnusAdductor Brevis

Anterior

ASISSartoriusTFLRectus Femoris

Lateral

Iliac CrestTFLGlute MediusGreater Trochanter

3

PosteriorPSISGlute MaxIschial TuberosityHamstrings

PALPATION

It’s easy to get lost!

Thoracic Landmarks

Even with inferior angle of scapulaT7

Even with medial border of scapulaT3

Posterior from jugular notchT2

Prominent; inferior to C - spineT1

4

Thoracic Rule of 3’s

Same levelT12

Midway betweenT11

One belowT10

One belowT7-T9

Midway betweenT4-T6

Same levelT1-T3

Lumbar / Sacral Landmarks

PSISS2

Bilateral DimplesL5

Level with iliac crestL4

Posterior to umbilicusL3

5

OBSERVATION

Remember what to look for from lecture

#2?

Some unique things to look at with the

hip

6

Craig’sTest

7

Pelvic Tilt / Lumbar Curvature

Postural Faults - Sagittal

Lordosis Sway Back Kyphosis Flat Back

Postural Faults - Frontal

8

Does the scoliosis disappear with flexion?

STRESS

BoneJointMuscle / TendonNerveVascular

9

BONE

Single Leg Stance

JOINT

10

Hip Scouring Test

Range of Motion

Active, Passive, Resistive

2 Joint MusclesHamstrings Rectus Femoris

Triplanar Muscles

11

Spring Test

SI Compression / Distraction

12

FABERE / Patrick

Gaenslen’sTest

LongSit

PosteriorRotation

AnteriorRotation

Left Leg

13

Passive ROM

DISC

Valsalva

14

Milgram

Well Straight Leg Raise

MUSCLE

15

Active / Resisted ROM

Trendelenberg’sSign

Thomas Test

Rectus Femoris Iliopsoas

16

NERVE

Beevor’s Sign

Quadrant Test

17

Femoral Nerve Stretch

Straight Leg Raise

Slump Test

18

Tension Sign / Bowstring

Kernig’s / Brudzinski

Side Gliding

19

Malingering

Hoover Test

PiriformisSyndrome

Straight leg raisingPassive internal rotationResisted external rotation in the seated position