Week 10

The in-class history taking assignment DX result was Avascular Necrosis of the Femur

Hip Orthopedic exam pdf

We will use the Goniometer tomorrow in Lab to evaluate ROM of hip

To determine retro version or anteversion of the femur in the hip joint, look at the knees and the toes before measuring. This will already give you an idea of what is going on.

• someone can meet the ROM normal ranges, but may have a lot more ROM with external or internal rotation compared to the opposite

For Lab tomorrow we will need:

• tape measures

• Goniometer

• We need gowns for 2nd hour

Leg length measurements:

• true method=

  • ASIS to medial malleolus

• Apparent method=

  • Umbilicus to medial malleolus

• Standing:

  • Greater trochanter to the floor

Circumferential measurements:

• Thigh=

  • 5” to superior patellar pole

  • 7” proximal to superior patellar pole

• Calf=

  • 5” distal to inferior patellar pole

Causes for leg length inequalities:

• diseases (ie. Polio)

• Fracture of femur or tibia

• Bone growth problems or damage to the epiphysial plate

• Prosthetic bone (ie. Knee or hip replacement)

Evaluation of leg length:

• Posture

• Supine leg length

• Long sit test

• Allis test

• Leg length measurement (supine)

• X-ray Scanogram

  • X-ray of femur and tibia that measures the bone

Allis Sign:

• bend knees @ 90*, with feet planted equal to the buttock, heels even

• Look straight on, for knee height difference

• Look from side, for one leg being more forward

  • If one leg is behind, the femur could be effected

  • If one leg is forward, Tibia could be effected

Heel lifts can help leg length inequalities

Hemipelvis= one illium is smaller than the other

Evaluation of SI joint

Gillet’s test

• aka: GIllette Test, SI motion palpating, Stork test, ipsilateral anterior rotation test, Step test, Sacral Fixation Test

The Orthopedic test:

• how you present with patient and give instructions

• Can you perform the test accurately

• What is the meaning of the test

• ROM measurements