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Hip Examination

A 5-step examination covering inspection, positional palpation, movement and special tests.

Musculoskeletal · Self-paced

Step 1. Introduction

  1. Hand hygiene

    Hand wash/rub

  2. Introduce yourself

    Introduce self

  3. Explain the purpose

    Explain purpose

  4. Consent

    Obtain consent

  5. Ask about pain or discomfort

    Ask if patient has pain/discomfort

Step 2. Inspection (Look)

  1. Knee alignment

    Knee alignment: valgus (knock knees) or varus (bowed legs)

  2. Squinting patellae

    Squinting patellae

  3. Skin changes

    Skin changes

  4. Muscle wasting

    Muscle wasting (quadriceps, gluteals)

  5. Lumbar lordosis

    Lumbar lordosis

  6. Leg length differences

    Leg length differences

  7. Other visible features

    Spasms, swellings, deformity, posture, symmetry

  8. Gait

    Gait: walk and turn – cadence (rhythm), pace length and height, balance; identify gait abnormalities (STRAWS)

  9. Report findings

    Report findings correctly

Step 3. Palpation (Feel)

  1. Supine position

    Patient supine:

  2. Temperature

    Assess temperature

  3. Pubis and groin — mention only

    Pubis and groin (mention only, do not perform)

  4. Anterior iliac crest

    Anterior iliac crest

  5. Greater trochanter

    Greater trochanter – trochanteric bursa

  6. Reassess leg length

    Reassess leg length with tape measure (ASIS to medial malleolus, each side)

  7. Prone position

    Patient prone:

  8. Posterior iliac crests

    Posterior iliac crests

  9. Sacroiliac joints

    Sacroiliac joints

  10. Buttocks

    Buttocks

  11. ROM

    ROM: extension (little or none – perceived extension is likely lumbar spine), rotational profile (IR/ER), foot-thigh angle, metatarsus adductus

Step 4. Move and Special Tests

  1. Passive flexion

    Passive flexion

  2. Passive internal and external rotation

    Passive internal and external rotation

  3. Passive abduction and adduction

    Passive abduction and adduction

  4. Passive extension

    Passive extension

  5. Crepitus and tenderness

    Palpate for crepitus; ask about tenderness

  6. Report findings

    Report findings correctly

  7. Thomas' test

    Thomas' test (patient supine) – detects occult hip flexion contracture

  8. Patrick's/FABER test

    Patrick's/FABER test (Flexion, ABduction, External Rotation; patient supine) – hip or sacroiliac joint disease

Step 5. Conclusion

  1. Thank the patient

    Thank patient and indicate they may redress

  2. Hand hygiene

    Hand wash/rub

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