An orthopaedic overview. HIP ASSESSMENT HISTORY  Chief Complaint:  Mechanism of injury:  Duration:  Location:LateralAnteriorOther  Radiation:GroinButtocks.

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Presentation transcript:

An orthopaedic overview

HIP ASSESSMENT HISTORY  Chief Complaint:  Mechanism of injury:  Duration:  Location:LateralAnteriorOther  Radiation:GroinButtocks Thigh Other  Severity when most severe: (0 to 10)  Catching:  When does pain occur? (rest; sitting; walk; run; stairs up/down; uneven ground; in/out car; during activity; after activity; morning; afternoon; night; other):  Relieving Factors:  Treatment to date:  Past history of knee injury or related hx:  Other medical history:  Medication:  Allergies:

PHYSICAL EXAMINATION “LOOK, FEEL, MOVE”

LOOK  Standing: Alignment rotation of femur, iliac crest height  Walking: Antalgic favours: Right or Left Trendelenburg  PWBNWB  AIDS: crutches/cane/wheelchair

LOOK Lying:Swelling Muscle wasting Flexion deformity Position Leg length discrepancy

FEEL Palpate points of maximal tenderness:  Bones: ASIS, Greater trochanter and bursa, Pubic symphysis, Ischial tuberosity (bursa and hamstring attachment), SI joints  Muscles & Tendons: Adductors, IT band (TFL), gluteus minimus/maximus, piriformis, Hamstring

MOVE Hip Range of Motion: Active Passive Resisted Active Passive Resisted  Flexion: (~120°)  Extension: (~20-30°)  Abduction: (~45-50°)  Adduction: (~20°)  Internal rotation: (~35°)  External rotation: (~45°)

Special Tests  Drehmann Sign  FAI testing: Rt: pos/neg Lt: pos/neg  Trendelenburg testRt: pos/neg Lt: pos/neg  Thomas test (flexion contracture/ITB tightness): Rt: pos/neg Lt: pos/neg  Ober test  FABER: NegPain: hip back  Functional tests: Hop

External rotation on hip flexion = OA

Trendelenburg test

MOVE Back ROM:  FlexionExtension Lateral flexion Rotation Sacro-iliac Kinetic Test Leg Lengths:Rt_____cm.Lt_____cm.