Intro + Vitals + General inspection.

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1) Inspection: Standing up

• Scars, Erythema, Atrophy, Deformityies, Swelling

• Leg-length discrepancy

• Trendelenburg test: ask the patient to stand on one leg while balancing on your shoulders (observe pelvis drop)

• Gait (any abn in Hip, knee, foot & length of stride

Lying down

• Hip or groin swelling

• Fixed flexion

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2) Palpation:

• Ant hip for lumps or tenderness

• Greater trochanter for tenderness

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3) Measure leg-length difference:

• True: ASIS to Medial malleoli

• Apparent: umbilicus to medial malleoli

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4) ROM:

• Active: Flexion, Extension, Abduction and adduction (+ against resistance)

• Passive: Internal & External rotation

• Power

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5) Special tests:

• Thomas test: Place your hand on pt lumbar spine and flex the hip, if the other hip flexes it suggests fixed flexion deformity

• FABER (flexion, abduction, external rotation): place foot of affected area over the opposite side (pain means hip issue not spine) and press the flexed knee (pain in sacroiliac area mean sacroiliac joints)

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 6) Thank the patient!

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7) To complete my exam, I would like to do:

• Check the pulses of the lower limb (dorsalis pedis / posterior tibial / popliteal)

• LL neuro exam

• One joint above and one joint below examination (Lumbar spine/ knee)

• The other hip examination