Clinical Examination of Hip Joint

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Clinical Examination of hip

 JointDr Terence Dsouza, M.S

Dept Of Orthopedics

Father Muller Medical College

Mangalore

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Seuence of examination

• !ait

• "ttitude of the lo#er lim$s

•

%nspection• &alpation

• 'OM

•

Measurements• Special tests

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!ait

 T#o main phases( Stance ) s#ing phase

 T*pes of gait(

"ntalgic gait+ Stance phase is less

 Trendelen$urg gait+ sound side sin-s

Short lim$ gait+ Shoulder dipping

!luteus maximus gait+ /urching gait

%n toeing gait+ in excessi0e femoralante0ersion

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 Terminologies

• "ttitude(

  &osition of the lim$ in an unalteredposition of ease .

• Deformit*(

  "n* de0iation from the normalanatom* of the lim$ is a deformit*.

  %f the deformit* goes uncorrectedo0ertime it might lead to contracture.

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1ormal attitude of the //

• 2ip in neutral

• 3nees in neutral #ith patella facingup#ards and out#ards

• "n-les in neutral.

%n pathological conditions( E.g  2ips in 45 degree 6exion, an-les in

75 degree plantar6exion etc

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%nspection%nspection "$o0e do#n#ards( %nspect the spine 8rst

/OO3 FO' E9"!!E'"TED /:M;"' /O'DOS%S

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 Thomas< test to re0eal FFD

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 Thomas< test+ Contd

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%nspection+ Contd

  /e0els of "S%S

  /im$ length

  S#elling in scarpas triangle  =asting of gluteal muscels>s#elling

in the gluteal area

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• /e0els of "S%S ) /im$ length

  "dduction deformit*( Shortening+ "S%S high

  "$duction deformit*(/engthening+ "S%S lo#

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&alpation

• /ocal rise of temperature

• /ocalised tenderness o0er ?oint line.

  "nterior ?oint line(  ;elo# ) lateral to mid@inguinal

point.

•

&alpation of !reater trochanter• &alpation of l*mph nodes ( External

iliac

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Deformities

Correction of deformities> Suarringthe pel0is(

Exaggerating the deformit* until"S%S is same le0el

• "dduction defomrit* + "$duct more

• "$duction deformit* + "dduct more

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Range of Mo0ement

• Flexion+ 5@A45

• Extension+5@AB

•

"$duction+5@5• "dduction+5@75+ can cross middle

A>7rd of other lim$

•

'otations( External+B ) %nternal+75

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Measurements

• "pparentmeasurements+ 9iphisternum toMedial Malleolus

•  True measurements+ after suaringthe pel0is

  To suare the pel0is( Exaggerate the

deformities

  +"S%S to MM

• ;r*ants triangle> 1elatons line

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"pparent Measurement

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;r*ants test@For :>/ 2ip&atholog*

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&alpa$le ;r*ants

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1elatons line

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Special tests

•  Trendelenurg test

•  Telescop* test

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 Trendelen$urgs test

"( 1ormal /fthip

;( "ected 't

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7 components of Trendelen$urgs

test

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 Than- *ou

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'eall*..........