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Hip Exam

Leg Length Discrepancy

January 1st, 2017


  • Look For

  • Shoulder drop
  • Abducted arm swing
  • Lateral pelvic tilt
  • Leg circumduction
  • Excessive knee flexion

True Leg Length Discrepancy

  • How to Assess

  • Measure from the anterior superior iliac spine (ASIS) to the medial malleolus
  • Causes of True Leg Length Discrepancy

  • Growth arrest - past fracture, osteomyelitis, osteosarcoma or osteonecrosis
  • Bony dysplasia
  • Blount's disease (tibia vara)

Apparent Leg Length Discrepancy

  • How to Assess

  • Measure from the umbilicus to the medial malleolus on both sides and compare
  • Interpretation

  • Apparent shortening - flexion contractures of the hip or knee
  • Apparent lengthening - abduction contractures of the hip, equinus deformity of the ankle
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