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Hip Exam
 
 
Hip Exam
 
 
Examination of the hips is performed to identify and localise pathology affecting the bones, joints or soft tissues associated with the hip.
The Patient
Look
Feel
Move
Special Tests
 
 

Muscle Inspection

 
 

Muscle Wasting

    • Look For

    • Decreased muscle mass. Note whether wasting is isolated to a single muscle or muscle group, isolated to the upper limb or generalised.
    • Causes of Muscle Wasting

    • Normal aging
    • Disuse
    • Malnutrition - poor diet, malabsorption, cancer
    • Denervation - trauma, ALS, Guillain-Barre Syndrome, neuropathy, polio
    • Muscular disorders - inflammatory myopathy, muscular dystrophies
    • Chronic disease - cancer, heart failure, COPD, infection, cirrhosis, kidney disease

Muscle Spasms

    • Look For

    • Spontaneous, uncontrollable contraction(s) of muscle. Note whether the spasm affects a single region, is generalised or affects the ipsilateral arm and leg.
    • Causes of Muscle Spasms

    • Exercise-induced spasm (cramping)
    • Dehydration
    • Electrolyte abnormalities - hyper/hyponatraemia
    • Hereditary dystonia - idiopathic, Huntington’s, Wilson’s
    • Acquired dystonia - brain damage, encephalitis, parkinsonism, brain tumour, stroke, drug-induced
    • Factitious dystonia

Fasciculations

    • Look For

    • Visible, spontaneous localised muscle contraction and relaxation.
    • Causes of Fasciculations

    • Benign / normal
    • Lower motor neuron disorders - ALS, radiculopathy, peripheral neuropathy, entrapment, syringomyelia, Creutzfeldt-Jakob disease
    • Metabolic disorders - thyrotoxicosis, tetanus, anticholinesterase medications
Last updated on January 1st, 2017
 
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Read More...

 Amerson JR. Inguinal Canal and Hernia Examination. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 96. Available from: http://www.ncbi.nlm.nih.gov/books/NBK423 Bailey R. The Role of the Trendelenburg Test in the Examination of Gait. Physical Therapy Reviews. 2009 Jun; 14(3): 190-197. Byrd JW. Evaluation of the hip: history and physical examination. N Am J Sports Phys Ther. Nov 2007; 2(4): 231–240. Dixon JK, Keating JL. Variability in Straight Leg Raise Measurements. Physiotherapy. 2000;86:361-370. Dutro JA. Obturator hernia. Am Surg. 2012;78:E217. Hallaceli H, Uruc V, Uysal HH, Ozden R, Hallaceli C, Soyuer F, Ince Parpucu T, Yengil E, Cavlak U. Normal Hip, Knee and Ankle Range of Motion in the Turkish Population. Acta Orthop Traumatol Turc. 2014; 48(1): 37-42. Hardcastle P, Nade S. The Significance of the Trendelenburg Test. J Bone Joint Surg Br. 1985 Nov; 67(5): 741-746. Harvey D. Assessment of the flexibility of elite athletes using the modified Thomas test. Br J Sports Med 1998; 32: 68-70. Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. The Lancet. 2003 Nov; 362(9395): 1561-1571. Martin RL, Enseki KR, Draovitch P, Trapuzzano T, Philippon MJ. Acetabular Labral Tears of the Hip: Examination and Diagnostic challenges. Journal of Orthopaedic and Sports Physical Therapy. 2006: 36(7): 503-515. Martin RL, Sekiya JK. The Interrater Reliability of 4 Clinical Tests Used to Assess Individuals with Musculoskeletal Hip Pain. Journal of Orthopaedic and Sports Physical Therapy. 2008 Feb; 38(2): 71-77. Rahman LA, Adie S, Naylor JM, Mittal R, So S, Harris IA. A Systematic Review of the Diagnostic Performance of Orthopedic Physical Examination Tests of the Hip. BM Musculoskeletal Disorders. 2013; 14: 257. Roach KE, Miles TP. Normal Hip and Knee Active Range of Motion: The Relationship to Age. Physical Therapy. 1991; 656-665. Sabharwal S, Kumar A. Methods for Assessing Leg Length Discrepancy. Clin Orthop Relat Res. 2008; 466: 2910-2922. Shailam R, Jaramillo D, Kan JH. Growth Arrest and Leg-Length Discrepancy. Pediatric Radiology. 2013. 43(S1): S155-S165. Smith NP, Kenny SE. Inguinal hernia and hydrocele. Surgery (Oxford). 2008;26:307-309. Whalen HR, Kidd GA, O'Dwyer PJ. Femoral hernias. BMJ: British Medical Journal. 2011;343:1271-1273.
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