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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*..........
