FOR HIP PATHOLOGY

SPECIAL TEST PROCEDURE POSITIVE SIGN INDICATION

FLEXION-ADDUCTION TEST
- Older children and young adults

- pt: supine
- PT flexes pt hip to a least 90 w/ knee - limited adduction w/ pain or
- hip disease/pathological hip
flex discomfort
- PT adduct flexed leg

HIP SCOUR (GRIND) TEST

- pt: supine
- PT flex and abducts pt hip
- irregular movement (bumps)
- apply compressive force
- pain
- move hip into abduction while
- apprehension
maintaining flexion and compressive
force

PATRICK’S TEST - lateral pain: superolateral and lateral

- pt: supine FAI
- PT place foot of pt on top of opposite - groin pain: iliopsoas pathology or
-pain provocation test leg knee
knee (figure of 4) psoas impingement
remaining above opposite leg
- PT slowly lowers knee of test leg - posterolateral pain: ischiotrochanteric
towards examining table impingement
- posterior pain: SI involvement

FOR LABRAL LESIONS

SPECIAL TEST PROCEDURE POSITIVE SIGN INDICATION
ANTERIOR LABRAL TEAR TEST - pt: supine
- PT move pt hip into full flexion, abd, ER
- pain
(starting position) (FADER)
- reproduction of pt’s symptoms w/ or
- PT then extend hip with IR and add
w/o click
(FADDIR) - anterior labral tear
- apprehension
(start) (end) *FABER to FADDIR
POSTERIOR LABRAL TEAR TEST
- pt: supine
- groin pain
- PT move hip to full flex, add, IR - labral tear
- apprehension
- PT then extend hip w/ ER and abd - anterior hip instability
- reproduction of pt symptoms w/ or w/o
- posteroinferior impingement
click
*FADDIR to FABER
(start) (end)
 FOR FEMORAL NECK STRESS FRACTURES
SPECIAL TEST PROCEDURE POSITIVE SIGN INDICATION
- pt: supine
HEEL-STRIKE TEST - groin pain - femoral neck stress fractures
- PT firmly strikes heel
PATELLAR-PUBIC PERCUSSION SIGN
- pt: supine
- PT place bell of steth over pubic
symphysis - duller sound - hip fracture
- PT percusses each patella with finger
(start with uninvolved side)

FOR PEDIATRIC HIP PATHOLOGY

SPECIAL TEST PROCEDURE POSITIVE SIGN INDICATION
- pt: supine w/ hips & knee 90 flex - asymmetry
ABDUCTION TEST - CDH
- PT passively abducts both legs - LOM
BARLOW’S TEST - pt: supine w/ legs facing examiner, hip
flex 90; knee fully flexed
- PT steadies opposite femur and pelvis - femoral head slips forward into
- hip is dislocated
- PT mid finger over greater trochanter; acetabulum with clunk
thumb adjacent to knee and thigh
- PT take into abduction while mid finer - femoral head slips out over the
- Hip is unstable/dislocatable
applies forward pressure behind greater posterior lip of acetabulum then reduces
trochanter again when pressure is removed
- PT then use thumb to apply pressure
backward and outward inner thigh
GALLEAZZI SIGN

- pt: supine w/ knee and hip flexed 90 - one knee is higher than the other - unilateral DDH

ORTOLANI’S SIGN
- pt: supine
- PT flex hip and grasp leg
- PT fingers place along outsides of thigh
to buttocks - click, clunk, jerk - DDH / hip has reduced
- with gentle traction PT abduct and
pressure is applied against greater
trochanter of each femur
 TELESCOPING SIGN

- pt: supine
- PT flexes knee and hip to 90 - a lot of relative movement
- PT push femur down to table - telescoping or pistoning: excessive - dislocated hip
- femur and leg are then lifted up and movement
away from the table

FOR LEG LENGTH

SPECIAL TEST PROCEDURE POSITIVE SIGN INDICATION
TRUE LEG LENGTH
- pt legs 15-20 cm apart & parallel to
each other
- PT measure from ASIS to lateral or
medial malleolus
- flat metal end of tape measure: distal
to ASIS and pusdh up against it
- thumb then presses the tape measure
against the bone
- index finger of other hand: distal to
lateral or medial malleolus

WEBER-BARSTOW MANUEVER
- pt: supine w/ hips and knees flexed
- PT stands at pt feet and palpate distal
- 1 leg shorter than the other; PT
aspect of medial malleoli w/ thumb
determine where the difference is by
- pt lifts the pelvis and return to starting
measuring the following:
position
1. iliac crest to greater trochanter
- PT passively extend pt legs and
a. coxa vara - <120
compare positions of malleoli using
b. coxa valga - >135
border of thumb
c. normal birth – 150-160
1. relative length of tibia
d. normal adult – 120-135
- pt: prone
2. greater trochanter to knee joint line
- PT place thumb transversely across
(lateral aspect) = femoral shaft
sole of feet
shortening
- knee flex 90
3. knee joint line on medial side to medial
2. femoral length
malleolus – tibial shaft shortening
- pt: supine with hips and knee flexed to
90
 FOR MUSCLE TIGHTNESS OR PATHOLOGY
SPECIAL TEST PROCEDURE POSITIVE SIGN INDICATION

pt: supine with ASISs level

- PT attempts to balance the lower limb
ABDUCTION CONTRACTURE TEST with pelvis

ADDUCTION CONTRACTION TEST

HIP ROTATOR TIGHTNESS

- pt: supine with hp and knee flexed 90

- ask pt to rotate hip medially (test
- <30-40 & end feel is muscle stretch - tight lateral rotators
lateral rotators)
- <40-60 & end feel is muscle stretch - tight medial rotators
- ask pt to rotate hip laterally (test
medial rotators)