Professional Documents
Culture Documents
Prepared by:
Sunil Baniya (Roll No. 3083)
4th Year, 3rd Batch
NAIHS-COM, sanobharayang, ktm
1. Pain
2. Swelling
3. Deformity
4. Stiffness
5. Inability to squat
6. Limp
7. Inability to walk
First exposed the part of body below midthorax except the private parts
1. Standing
2. Sitting
3. Lying in couch
a) Look/ Inspection:
Front:
Level of ASIS (for pelvic tilting)
Limb shortening
Side:
Increased lumbar lordosis (hyperlordosis)
Kyphosis (thorax)
Behind:
Gluteal muscle wasting
Scoliosis
Sinus, scars
Normal
Antalgic gait
Circumduction gait
Schuffling gait
Ask patient to stand on normal leg first + opposite leg to flex at knee around 90°
If the ASIS of normal side is lower than the affected side, this test is positive.
a) Look:
Level of ASIS
Attitude of leg
Lumbar lordosis
b) Feel:
i) Temperature:
At groin
Greater trochanter
Gluteal region
ii) Tenderness:
Over ASIS
Over lesser trochanter (externally rotate the leg & feel over the LT)
Findings:
Present = normal
Absent = vascular sign of Narad?? (in central hip dislocation)
iv) Any swelling: examine it
Groin region
c) Move :
First actively, if not possible (restricted) then only passively
Flexion = 120°
Extension = 5-20°
Adduction = 25°
Abduction = 40°
Special tests:
1. Thomas test
2. Adduction and abduction deformity
3. Patrick test (Faber sign)
4. Galezzi test (Allis’ sign)
1. Thomas test:
Put one hand behind lumbar region on palm facing towards bed
Measure the angle at hip ( flexion with bed) Figs : A and B: Thomas test
Ask patient to lie on bed as straight as he can with both legs parallel to each
other
Findings:
Pelvis square : no deformity
Patient supine
Pain over hip joint means Faber sign +ve thus hip joint pathology Fig: Faber test
Note
#if thighs are parallel: discrepancy is above knee joint. Again draw a
Bryants triangle from ASIS and GT => measure the distance from GT toFig : Bryant's triangle
point of cross section (on both side)
Findings: if both side equal, then infratrochanteric cause & if not equal,then
supretrochanteric cause like OA of hip
d) Measurement:
Apparent length:
On both side
Measure from xiphisternum to the lower border of medial malleoli (without squaring the
pelvis i.e; length with compensatory mechanism)
Measure length from ASIS to lower border of medial malleoli (length without
compensatory mechanism)