Hip

Question 1

what is the trendelenburg test?

Answer 1

1. Stand behind patient and observe iliac crest/top of hip of unsupported
   leg
2. Have patient stand on one leg – normally gluteus medius muscle on
   supporting side should contract when leg leaves ground preventing
   unsupported hip from dropping (instability)
3. Pelvis should elevate on unsupported side

Positive => pelvic on unsupported side remains in position or descends

Question 2

what are the findings of trendelenburg test?

Answer 2

Weak or non-functioning gluteus
medius muscle on supported side
(+) pelvic lateral tilt – weak hip
abductor muscles (glute med),
neurologic or muscle conditions
deficit
(+) pain in SI on support leg – SI
joint pathology

Question 3

what is yeoman sign

Answer 3

1. Patient lying prone
2. Examiner lifts knee to 90 degrees and extends hip

Positive => pain in SI joint or lumbar region

Question 4

what are the findings for yeoman sign

Answer 4

SI joint pain = pathology in anterior SI ligaments

Lumbar pain = lumbar involvement

Anterior thigh paresthesia = femoral nerve stretch

Question 5

what is the sign of the buttock test

Answer 5

1. Patient supine
2. Examiner performs unilateral SLR test
3. If restriction or pain found, examiner flexes patients’ knee while
   holding thigh in same position
4. After knee is flexed – examiner tries to increase the flexion of hip
5. Negative would allow for more hip flexion that is painless (when knee
   is bent) and would indicate lumbar spine or tight hamstring issues of
   pain

Positive => cannot increase hip flexion

Question 6

what are the findings of the sign of the buttock test

Answer 6

Pathology in buttock – bursitis,
tumour, or abscess

Question 7

what is the noble compression test

Answer 7

1. Patient supine with knee flexed to 90 degrees
2. Examiner applies pressure with thumb to lateral femoral condyle or 1-2 cm proximal to it
3. While maintaining pressure patient slowly extends knee

Positive => pain at approximately 30 of flexion

Question 8

what is the finding for noble compression test

Answer 8

(+) – pain over lateral femoral
epicondyle or palpable tendon
snapping => iliotibial band
friction syndrome

Question 9

what is the thomas test

Answer 9

1. Patient supine with pelvis level and square to trunk
2. Stabilize pelvis by placing hand under lumbar spine and flex both
   hips, bringing knees to chest
3. Feel for flattening of lumbar spine – from this point on only hip
   flexion will allow leg to move
4. Patient extends one leg and lets it rest on the table

Positive => leg remains flexed and will not lie flat on the table

Question 10

what is the finding for the thomas test

Answer 10

Tight hip flexors (same side as leg up) – iliopsoas

Question 11

what is the piriformis test?

Answer 11

1. Patient lying on side; involved side up
2. Flex upper hip (testing side) 60-90
3. Flex knee 90
4. Examiner stabilizes hip with free hand; place downward pressure with
   other hand

Positive => pain in piriformis area or recreation of symptoms

Question 12

what is the findings for the piriformis test?

Answer 12

Tight piriformis or piriformis
syndrome

(+) radicular leg or buttock pain –
piriformis syndrome, piriformis
myospasm

Question 13

what is the piriformis length test?

Answer 13

1. Patient lying prone with knees slightly apart
2. Flex both knees to 90
3. Slowly lower the legs away from midline while keeping knees
   together

Positive => decreased internal rotation (stretching of piriformis)

Question 14

what is the findings for piriformis length test

Answer 14

Hypertonic (shortened, tight) piriformis

Question 15

what is the pace abduction test

Answer 15

1. Patient sitting with legs over table and knees close together
2. Knees flexed to 90 and examiner places hands on lateral aspect of
   knee joint bilaterally
3. Resist patients’ actions of external rotation (try to separate legs)
4. Be sure to not overpower – match resistance

Positive => pain in piriformis area or recreation of symptoms (external
rotation)

Question 16

what is the finding for pace abduction test

Answer 16

tight piriformis

Question 17

what is the Ely’s test/ Nachlas test

Answer 17

1. Patient lying prone
2. Knee is flexed slowly, attempting to stretch quadriceps

Positive Ely’s => hip on ipsilateral side will spontaneously flex and hike up

Positive Nachlas => pain felt in front of thigh before full range is reached
(rectus femoris) OR pain in lumbar spine (lumbar spine)

Question 18

what are the findings for Ely’s test/Nachlas test

Answer 18

Ely’s
(+) knee flexion pain – femoral
nerve or root compression, quad
muscle contracture

(+) hip extension pain – femoral
nerve or root compression,iliopsoas muscle strain or
inflammation

Nachlas – tight rectus femoris or
lumbar spine
(+) local pain – SI/lumbar/knee
ligament sprain, quad strain

(+) radiating pain – femoral nerve

Question 19

what is the Faber’s test

Answer 19

1. Patient lying supine
2. Examiner places foot of involved side on the opposite knee
3. Examiner applies over pressure downwards on flexed knee and
   opposite side of ASIS

Positive => increased pain in SI joint or hip joint

Question 20

what is the findings for Faber’s test?

Answer 20

Pathology of SI joint or hip joint

Question 21

what is the Hibb’s test

Answer 21

1. Client lying prone with knee flexed to 90 degrees
2. Examiner internally rotates hip by pulling the ankle laterally while
   stabilizing sacroiliac joint on opposite side

Positive => pain or reduced mobility on testing side at the sacroiliac joint

Question 22

what is the findings for the Hibb’s test

Answer 22

Posterior sacroiliac ligament
pathology
(+) sacroiliac pain – SIJ pathology
(+) hip pain – hip lesion
(+) radicular pain – piriformis entrapment of sciatic nerve

Question 23

what is the Gaenslen’s test

Answer 23

1. Patient lying supine
2. Ask patient to bring both legs into chest
3. Shift patient to side of the table so one buttock is over edge of table
4. Drop unsupported leg over the edge while opposite leg remains flexed;
   examiner can provide over pressure to help stretch leg

Positive => pain in SI joint or pain in hip on the side of the lowering leg

Question 24

what is the findings for Gaenslen’s test

Answer 24

SI joint pathology or hip pathology

Question 25

what is the quadrant (Souring) test

Answer 25

1. Examiner flexes and adducts patient’s hip so hip faces patient’s opposite shoulder and resistance to movement is felt 2. Slight resistance is maintained – patients’ hip is taken into abduction while maintaining flexion in an arc movement Positive => as movement is performed, examiner should look for any irregularity in movement (bumps, pain, apprehension)

Question 26

what is the finding for quadrant (souring) test

Answer 26

Hip pathology – OA or bursitis

Question 27

what is the functional leg length discrepancy

Answer 27

1. Patient lying supine with hips and knees flexed 2. Examiner stands at patient’s feet and palpates distal aspect of medial malleoli with the thumbs 3. Patient lifts pelvis from table and returns to starting position 4. Examiner passively extends patient’s legs and compares position of the malleoli using borders of thumb Positive => thumbs are different levels

Question 28

what is the finding for functional leg length discrepency

Answer 28

Functional leg length discrepancy

Question 29

what are the special test for groin strain

Answer 29

resisted and passive ROM

Question 30

what are the special test for hamstring strain

Answer 30

resisted and passive ROM

Question 31

what are the special test for snapping hip

Answer 31

- Fabere - Gaenslens - thomas test - yeomans - obers - obers modified

Question 32

what are the special test for acetabular labral tear

Answer 32

- impingement test - Resisted SLR - Faebere

Question 33

what are the special test for Hip DJD

Answer 33

- scour test - Fabere