Hip Joint Orthopedic Tests
Iliac Crest, ASIS, & AIIS
Greater Trochanter
Hip Joint
Tensor Fasciae Latae Muscle
Femoral Triangle
Congenital Hip Dysplasia
Congenital hip dysplasia is a condition in which the
femoral head is displaced out of the acetabular cavity.
Often bilateral. Girls affected more often than boys.
The acetabular cavity is shallow or more vertical than
normal.
Congenital Hip Dysplasia
Clinical Signs and Symptoms
Decreased hip flexibility
Limited hip abduction
Painless limp
Hip pain
Shortened extremity
Allis Test
Procedure: Infant supine, flex the knees, Feet should
approximate one another on the table.
Positive Test: A difference in the height of the knees is
a positive test.
Short knee on the affected side – posterior displacement
of the femoral head or a short tibia.
Longe knee on the affected side – anterior displacement
of the femoral head or increase in tibia length.
Allis Test
Ortalani’s Click Test
Procedure: Infant supine. Grasp both thighs with
thumbs on the lesser trochanters. Flex and abduct the
thighs b/l.
Positive Test: Palpable or audible click is a positive
sign. The click signifies displacement of the femoral
head in or out of the acetabular cavity.
Ortalani’s Click Test
Hip Fractures
Hip fractures occur most frequently in the elderly
population.
Most common types are intertrochanteric and
intracapsular.
Intertrochanteric and femoral head fractures typically
do NOT disrupt the blood supply.
Intracapsular fractures disrupt the blood supply to the
femoral head and can lead to avascular necrosis.
Hip Fractures
Clinical Signs and Symptoms
Hip pain
Shortened extremity
Externally rotated extremity
Referred pain to medial thigh
Anvil Test
Procedure: Patient supine. Tap the inferior calcaneous
with your fist.
Positive Test: Local pain in the hip joint may indicate a
femoral head fracture or joint pathology.
Pain in the thigh or leg secondary to trauma may
indicate a femoral, tibial, or fibula fracture.
Pain local to the calcaneous may indicate a calcaneal
fracture.
Anvil Test
Hip Contracture
A hip joint contracture is a condition of soft tissue
stiffness that restricts joint motion.
This can be caused by immobility due to spasticity,
paralysis, ossification, bone trauma, or joint trauma.
A frequently moved joint is unlikely to develop a
contracture deformity.
The joint capsule, ligaments, or muscle tendon units
can be involved.
Hip Contracture
Clinical Signs and Symptoms
Stiff hip joint
Limited hip range of motion
Inability to position joint in the neutral position
Hip joint pain on range of motion
Thomas Test
Procedure: Supine patient. Approximate each knee to
the chest one at a time. Palpate quadriceps on the
unflexed leg.
Positive Test:
No tightness – suspect restriction at the hip joint
structure or joint capsule.
If tightness is palpated on the side of the involuntary
flexed knee – hip flexure contraction is suspected.
Thomas Test
Ely’s Test
Procedure: Patient prone. Grasp ankle and passively
flex the knee to the buttock.
Positive Test: If the patient has a tight rectus femoris
or hip flexion contracture, the hip on the same side
will flex, raising the buttock off the table.
Ely’s Test
General Hip Joint Lesions
Common problems associated with the hip joint
include the following:
Osteoarthritis, sprains, fractures, dislocations, bursitis,
tendinitis, synovitis, and avascular necrosis of the
femoral head.
The following tests determine whether a general lesion
of the hip is present. Further diagnostic imaging can
determine the exact pathology.
General Hip Joint Lesions
Clinical Signs and Symptoms
Hip pain
Shortened extremity
Externally rotated extremity
Referred pain to medial thigh
Patrick Test (Faber)
Procedure: Patient supine. Flex leg and place foot flat
on table. Grasp femur and press it into the acetabular
cavity. Cross leg to opposite knee. Stabilize ASIS
opposite and press down on knee of side tested.
Positive Test:
Pain in the hip – inflammatory process in the hip joint
Pain secondary to trauma – may indicate fracture
Pain may indicate avascular necrosis of femoral head
Faber – Flexion, abduction, & external rotation
Patrick Test (Faber)
Trendelenburg Test
Procedure: Patient standing. Grasp waist. Thumbs on
PSIS b/l. Instruct patient to flex one leg at a time.
Positive Test:
If the patient cannot stand on one leg because of pain
If the opposite pelvis falls or fails to rise
This tests the integrity of the hip joint opposite the side
of hip flexion
Trendelenburg Test
Laguerre’s Test
Procedure: Patient supine. Flex the hip and knee to
90degrees. Rotate the thigh outward and the knee
medially. Press down on the knee with one hand and
pull up on the ankle with the other.
Positive Test: This test externally forces the head of the
femur into the acetabular cavity.
May indicate an inflammatory process in the joint such
as osteoarthritis.
Pain secondary to trauma – suspect fracture of the
acetabular cavity or rim.
Laguerre’s Test