IO

 hip joint  the pelvic girdle and the lower

limb.
 The femoral head  ball.
 acetabulum  socket.
 strong and stable multiaxial ball and socket
type of synovial joint
 designed for stability over a wide range of
movement.
General Inspection
 Observing the patient standing and then
walking.
 Ask patient to walk without shoes
 Inspect your patient from the front, the back
and the side
• Procedure:
• Standing
• Raise 1 knee toward the
chest
• Observe gluteal fold

• Clinical Significance:
the gluteal fold will drop
below the level of the
contralateral side if the
gluteal muscles are weak
 Always watch the patient`s face!
 Where is the tenderness ?
 Always compare one side with
another!
 Active and passive movement.
Active should be teasted first.
 Range of motion testing
Normal 120-135 degrees

Normal 20-30 degrees

 Normal abduction 45- 50 degrees

• Normal adduction 35-40 degrees

 Normal interrnal rotation 35- • Normal external rotation 40-
40 degrees 45 degrees
 Procedure: supine position, pull one knee
chest, hold.observe the other knee flexion
 Clinical significance: (+) if the knee flex 
avoid stressing. contracture rectus femoris
 Procedure:
 patient lying on the side.
 lower leg is flexed at the
knee for stability.
 The uppper leg straight
 Raise the leg  then
release.
 Clinical significance:
patient disease hip joint
difficult or painfull to
complete this test solely
rom restriction
 Procedure:
 supine,
 mark ASIS n medial
malleolus
 meassure n record the
distance, compare the
numbers
 Clinical significance: if the
difference greater than 1 ¼
inch,reteable impairment n
is an important factor to
consider in stabilization of the
patient who presents with
lower back n pelvic pain
True leg length Appearent leg length
 Procedure:
 keeping the leg straight,
 foot is manipulated
medially (internal rotation)
and laterally (external
rotation
 Clinical significance:Pain
(+) suggests
inflammation, infection,
or trauma.
Procedure:
 supine.
 flex the knee on the side
being tested n abduct n
externally rotate femur
outer malleolus rests on
the opposite knee.
 stress by pressing
downward on the flex knee

Clinical significance:
 iliopsoas spasm  inability
to abduct the leg on the
side being tested.
 sacroiliac joint lession is
indicated by pain within
sacroiliac joint
 Procedure:
 baby relaxed,
 hips n knees fixed to 90 degrees.
 examined one at a time.
 grasps baby’s thigh with middle finger
over greater trochanter n lifts thigh to
bring femoral head from its dislocated
posterior position to opposite the
acetabulum.simultaneusly, thigh
gently abducted,reducing femoral
head into acettabulum. In positive
finding examiner senses reduction by
palpable,nearly audible “clunk”
 Procedure: (for infant up to 6
months of age).
 supine.
 Our hands so that thumb lies
along the patient’s inner thigh
n the index n middle fingers lie
on the outer thigh
 Apply pressure along posterior
to anterior plane to produce a
palpable click.repeat

 clinical significance supine:

 if the click occurs when
pressure is applied from
anterior to posterior plane, the
infant was unstable congenital
hip dislocation
 Procedure:
 supine with the legs and the feet
bent on the table,
 the heels are approximately
parallel to each other. Observe
the height of the femoral
condyles and of tibia.

 Clinical significance: shortening

may be a result of posterior hip
dislocation, in wihch case the
femoral shaft on the involved side
will be pulled backward creating the
illusion of unequal femoral heights
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