S.Sattari,MD Pelvis, Hip, and Thigh examination

pelvic ring protects vital internal structures

A stable central base for human locomotion A foundation for the spine and upper body A point of origin or insertion for many muscles of the thorax, the hip, and the thigh

ball-and-socket design considerable motion in three planes second only to the shoulder in the range and complexity of its potential motion.

A. iliac crest; B. anterior superior iliac spine; C, pubic symphysis; D, pubic tubercle; E sartorius; F, lateral femoral cutaneous nerve; G. femoral artery; H, tensor fascia lata;I, anterior interior iliac spine; J, hip joint; K, lesser trochanter. 2 cm lateral and 2 cm distal groin pain

A, rectus femoris; B, vastus medialis; C, vastus lateralis; D, iliotibial tract; E, adductor longus; F gracilis; G, sartorius. meralgia paresthetica

A, iliac crest; B, anterior superior iliac spine; C. posterior superior iliac spine; D, gluteus medius; E, tensor fascia lata; F. gluteus maximus; G. greater trochanter. Nelaton's line

A,iliac crest;B, posterior superior iliac spine; C, sacroiliac joint; D. gluteus maximus; E, sacrum; F, coccyx; G, ischial tuberosity; H, greater trochanter; I, piriformis; J, quadratus femoris; K, gluteal fold; L, sciatic notch. 167

A, biceps femons; B. semitendinosus; C semimembranosus

ALIGNMENT

Pelvic Obliquity

True leg length discrepancy Functional, or apparent, leg length discrepancy

True Versus Functional Leg Length Discrepancy In a true leg length discrepancy, the actual length of the patient's two lower limbs, when measured from the femoral heads to the plantar surfaces of the feet, is different. Causes: one of the bones of the lower limb actually being shorter or longer than its counterpart on the other side: varus or valgus deformities of the femoral neck congenital anomalies of the femur or tibia growth disturbances of the femur or tibia..

Functional leg length discrepancy Apparent leg length discrepancy, the patient's two lower limbs are identical in length; however, other factors, such as joint or muscle contractures, cause one of the lower limbs to function as if it were shorter or longer than the other. causes : contractures at the lumbosacral junction due to scoliosis or other causes posttraumatic deformities of the pelvis abduction or adduction contractures of the hip or flexion contracture of the knee

Measuring a true leg length discrepancy Measuring a functional leg length discrepancy

functional limb length discrepancy

True leg length Comparing femoral lengths

Comparing tibial lengths

GAIT

Trendelenburg's Gait not quite strong enough

Abductor limp painful hip joint osteoarthritis of the hip

Range Of Motion

Thomas Test A, Preparation. B, Assessing extension of the right hip. C, Demonstrating flexion contracture of the right hip (arrow). D, Assessing flexion of the right hip

Special Tests TESTS FOR JOINT CONTRACTURES

Ober's Test

Ely's test

Tripod sign

SCREENING TESTS FOR TENDINITIS

piriformis syndrome piriformis test &

Patrick's Test FABER test: Flexion-ABduction External Rotation

Gaenslen's Test

Trendelenburg's test.