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Clinical Examination of the Pelvis and Thigh

Examination Map HISTORY

Past Medical History

History of the Present Condition

Mechanism of Injury

FUNCTIONAL ASSESSMENT

Gait Evaluation

INSPECTION

Hip Angulations

Angle of inclination

Angle of torsion

Inspection of the Anterior Structures

Hip flexors

Inspection of the Medial Structures

Adductor group

Inspection of the Lateral Structures

Iliac crest

Nélaton's line

Inspection of the Posterior Structures

Posterior superior iliac spine

Gluteus maximus

Hamstring muscle group

Median sacral crests

Leg-Length Discrepancy

Palpation

Palpation of the Medial Structures

Gracilis

Adductor longus

Adductor magnus

Adductor brevis

Palpation of the Anterior Structures

Pubic bone

Inguinal ligament

Anterior superior iliac spine

Anterior inferior iliac spine

Sartorius

Rectus femoris

Palpation of the Lateral Structures

Iliac crest

Tensor fasciae latae

Gluteus medius

Iliotibial band

Greater trochanter

Trochanteric bursa

Palpation of the Posterior Structures

Median sacral crests

Posterior superior iliac spine

Gluteus maximus

Ischial tuberosity

Ischial bursa

Sciatic nerve

Hamstring muscles

JOINT AND MUSCLE FUNCTION ASSESSMENT

Goniometry

Flexion

Extension

Abduction

Adduction

Internal rotation

External rotation

Active Range of Motion

Flexion

Extension

Abduction

Adduction

Internal rotation

External rotation

Manual Muscle Tests

Hip flexion (iliopsoas)

Knee extension (rectus femoris)

Hip extension

Abduction

Adduction

Internal rotation

External rotation

Passive Range of Motion

Flexion

  • Thomas test

  • Hip flexion contracture test

  • Ely's test

Extension

Abduction

Adduction

Internal rotation

External rotation

JOINT STABILITY TESTS

Stress Testing

Not applicable

Joint Play Assessment

Passive range of motion

NEUROLOGICAL EXAMINATION

Lower Quarter Screen

Sciatic Nerve

Femoral Nerve

VASCULAR EXAMINATION

Distal capillary refill

Distal pulse

Posterior tibial artery

Dorsal pedal artery

REGION-SPECIFIC PATHOLOGIES AND SELECTIVE TISSUE TESTS

Iliac Crest Contusions

Muscle Strains

Hamstring tear

Quadriceps Contusion

Slipped Capital Femoral Epiphysis

Iliotibial Band Friction Syndrome

Legg-Calvé-Perthes Disease

Femoral Neck Stress Fracture

Degenerative Hip Changes

Labral Tears

Hip subluxation

Athletic Pubalgia

Osteitis Pubis

Piriformis Syndrome

Snapping Hip Syndrome

Internal cause

External cause

Intra-articular cause

Bursitis

Trochanteric bursitis

Ischial bursitis

History

Table 9-1Differential Diagnosis Based on the Location of Pain*

Inspection

FIGURE 9-1

Deviations in the angle of inclination.

Image not available. Selective Tissue Test 9-1: Clinical Determination of the Angle of Torsion

Image not available.

This procedure is most easily performed by two clinicians: one to maneuver the leg and the other to goniometrically measure the angle of ...

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