HIP examination proforma for MS DNB ORTHO PRACTICAL EXAM

HIP EXAMINATION PROFORMA








Performed in standing, supine and lateral positions

Inspection

  • lumbar lordosis
  • attitude of limb
  • levels of ASIS, patellae, malleoli
  • swelling--gluteal region ,Scarpa’s triangle, trochanteric region
  • scars, sinuses
  • skin over the joint
  • muscle wasting

Palpation

  • temperature
  • tenderness-anterior joint line, posterior joint line
  • trochanteric palpation
    • level
    • trochanteric tenderness- superficial /deep / transtrochanteric
    • trochanteric surface--thickening / irregularity
  • palpable swelling
    • hard : femoral head, bony neoplasm
    • firm : soft tissue neoplasm
    • soft : cold abscess
  • Vascular sign of Narath

Movements

  • Thomas’ test for flexion deformity of the hip
  • determination of abduction / adduction deformity
  • Flexion
  • Extension
  • Abduction
  • Adduction
  • External & internal rotation in hip extension (prone) & with hip flexed 90 degrees
  • active/passive
  • lag/deformity/arc
  • compare with opposite side
  • Differential rotation
  • Knee to axilla sign

MEASUREMENTS

  • apparent length
  • true length-
supratrochanteric
  1. Bryant’s triangle
  2. Nelaton’s line
  3. Shoemaker’s line
infratrochanteric segmental lengths- femur, tibia
  • thigh & calf girth
  • Gluteal wasting
  • Galeazzi test

Special tests

  • Trendelenburg test
  • Trendelenburg sign
  • telescopy

Other tests

  • Gait
  • Function-ambulation distance, walking, sitting, squatting,stairs
  • Other joints-Hip, SI joint , knee joint
  • lymph nodes (inguinal,external iliac group)
  • Per abdomen examination
  • Per rectal examination

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