Hip & Thigh Eval: History & observation
In your opinion…
A basketball player was going up for a lay up and got
her feet taken out from under her. She lands hard on her
left hip.
 What questions would you ask to gather clues
about what is going on?
 What are some relevant observations to make
regarding their body?
Notes
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

Objectives: Identify…
 Pertinent information to gather during a hip &
thigh evaluation
 Important observations to make during a hip &
thigh evaluation
Introduction
 Must understand anatomy & biomechanics
 Examination process is on-going
 Initial  rehab  RTP
 Must be systematic and methodical
 Must understand differential diagnosis (DDx)
o Options that a specific injury could be
o Pathologies often have similar S&S
 Rule out emergency situations quickly
o If unsure,
Hops technique
History
 Start with generic history questions
o
o Age
o Occupation / sport / position etc.
o General health condition
o Activity level
o Medications

o What happened?
o Who did you see?
o What did they tell you?
o How long were you out?
o Has it fully resolved?


Mechanism of injury
o How did it happen?
Tension = sprain; fracture;
Torsion =
/
;
fracture
Compression =
;
Shear =
; sprain
Mechanism of Injury – Hip & Thigh specific
o Compression
o
of the
femur
o
Ask these questions regarding PAIN
o P-rovocation – what causes it? What
makes it better?
o Q-uality – what does it feel like?
Neurological symptoms?
o R-egion – where does it hurt? Can you
point w/one finger?
o S-everity – how bad does it hurt?
(
)
o T-iming – when does it hurt? How long?
Sounds & sensations
o Did you hear any sounds? Did you hear
any pops, crackles, snaps, clicking?
 What could this indicate???
o Did you feel anything unusual?
Specific to the HIP & THIGH
o Link the anatomy to the pathology
 AKA:
o
Focus on the onset/duration
 Link the start of symptoms to
.
o
Prior medical conditions
 Congenital
Observation
 When does this begin?
 Compare each side bilaterally to identify what is
normal for that person
 We look for:
o Deformity,
, edema,

Gross motor function
o Can the athlete move the limb on their
own through normal function?
o Can they
?
Hip & Thigh Eval: History & observation
 Leg alignment
o Genu valgum –
o Genu varum –
o Squint eye patella –
o Frog eye patella –
 Additional examinations:
o Q-angle – degree of
alignment between
& tibia
o Leg Length
o Gait analysis
 Q-Angle
o Measured from the:
to the
the
Notes
& from
to the
Critical thinking…
A hurdler comes to see you about pain she is
having in her anterior hip. She was at practice
yesterday and on her last hurdle she felt a
“funny pull” in her lead leg. There was an
immediate shot of pain to the front of her hip
bone, and she immediately had to stop running.
She iced it when she got home and took some
meds for the pain. Today she felt worse. She
could barely walk and wasn’t able to lift her leg
to go up/down the stairs. Now her hip is all
bruised and is very tender to the touch.
o What anatomy would you consider
inspecting & palpating? List all
possibilities—bones, landmarks,
muscles, ligaments, etc.
o What other history questions would you
ask? List 5.
o What injury/injuries do you think this is?
o How would you treat this athlete
initially?
 Anatomy:

Hx questions:
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Diagnosis:
Immediate Care:
