Spine & Neck; Hip

Aro │ Nugal │ Morada │ Paras │ Somera

Outline
Spine

Neck

Hip
Title and Content Layout with Chart
6

0
Category 1 Category 2 Category 3 Category 4

Series 1 Series 2 Series 3

Two Content Layout with Table
Class Group A Group B • First bullet point here
Class 1 82 85 • Second bullet point here
Class 2 76 88 • Third bullet point here
Class 3 84 90
Two Content Layout with SmartArt
• First bullet point here Group A
• Second bullet point here • Task 1
• Task 2
• Third bullet point here
Group B

• Task 1
• Task 2

Group C

• Task 1
• Task 2
Title and Content Layout with List
• First level
• Second level
• Third level
• Fourth level
• Fifth level
Hip Maneuvers
Flexion
• Examiner’s hand is placed under the
Supine patient’s lumbar spine
Patient

• Patient bends each knee up to the chest

and pull it firmly against the abdomen

• Patient’s back touches examiner’s hand

→ normal flattening of the lumbar
lordosis
• Further flexion arises from the hip joint
Flexion
• Inspect the degree of flexion at the hip
Thigh and knee
against
Abdomen

• Normally, the anterior portion of the

thigh can almost touch the chest wall

• Note whether the opposite thigh remains

fully extended, resting on the table
Flexion Deformity of the Hip
• As the opposite hip is flexed, the
Thigh affected hip does not allow full hip
against extension
Chest

• The affected thigh appears flexed

• Flexion deformity may be masked by an

increase in lumbar lordosis and an
anterior pelvic tilt
Extension
• Examiner extends the thigh in a posterior
Prone direction (towards him/herself)
Patient

• Alternatively, the patient can be placed

in a supine position

• Carefully position the patient near the

Supine edge of the table and extend the leg
Patient posteriorly
Abduction
• Examiner stabilizes the pelvis by
pressing down on the opposite ASIS with
Supine one hand
Patient

• With the other hand, examiner grasps the

ankle and abducts the extended leg until
he/she feels the iliac spine move

• This movement marks the limit of hip

abduction
Abduction Deformity
• Restricted abduction and internal and
external rotation are common in hip OA

• The LR for resisted external rotation due

to pain is as high as 32.6

• Likelihood ratio is an alternate method

LR of assessing the performance of a
diagnostic test
Adduction
• Patient is placed in a supine position

• Examiner stabilizes the pelvis, holds one

Supine ankle, and moves the leg
Patient

• The leg is moved medially across the

body and over the opposite extremity
External & Internal Rotation
• Examiner flexes the leg to 90° at hip and
Supine knee, stabilizes the thigh with one hand,
Patient grasps the ankle with the other, and
swings the lower leg

• Medially → external rotation at the hip

• Laterally → internal rotation

• It is the motion of the head of the femur

in the acetabulum that identifies these
movements
Acetabular Labral Tear

• Pain with maximal flexion and adduction

and internal rotation or with abduction
and external rotation with full extension