MS 1 hip special tests
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FABERE aka Patrick test - the acronym stands for...?
- External Rotation
FABERE aka Patrick test - what is its goal?
to differentiate btwn hip and SI joint issues
how to perform the FABERE aka Patrick test
- put pt in position of figure of 4. If pt can't maintain or achieve this, it's a hip problem.
- Then put a hand on the ASIS of the straight leg to stabilize the pelvis and one on the distal femur of the bent one. Push the bent leg towards the table. Pain as this is done indicates pt is positive for SI joint issues
Trendelenburg test - tests what? how is it done?
- abd weakness
- have pt do single leg stance and see if pelvis falls to opp side
Ely's Test tests what?
rectus femoris tightness
how to do Ely's test
- pt is prone w 1 knee flexed
- PT pushes that heel towards pt's tush until blockage, pain, or tush
Ober's test - tests what?
Ober's test - how to do it?`
- pt is sidelying
- PT brings upper leg into extension, then lowers it into adduction
if there's an inability to adduct or leg moves into flexion, indicates TFL tightness (healthy supple TFL and ITB should let the leg fall to the table)
Thomas Test tests for what?
compares iliopsoas, rectus femoris, and TFL tightness
Thomas Test - how? what findings indicate what?
pt supine, brings 1 knee to chest
- opposite/ contralateral hip flexes without knee extension- tight iliopsoas
- hip abducts during the test- tight tensor fascia lata
- knee extension occurs- tight rectus femoris
Ortolani Click indicates what?
- congenitally disclocated hip
- the femoral head is leaving the joint and making the sound - can be heard walking or w any flexion
leg comes in and out - seen in dislocated hips
how to test for a fracture of the hip or femur
- pt supine, stethescope over pubic symphysis
- tap patella on symptomatic side and on asymptomatic side
- positive finding: diff in sounds btwn sides (sound'll be less intense on side w fracture)
- only do this test if it's indicated by pain, a fall, asymmetry
Noble Compression Test indicates what?
IT band tension or friction problems
Noble Compression Test - how?
- pt supine, hip flexed to 90 degrees
- PT applies pressure w thumb to lateral femoral condyle over IT band
- maintain pressure while pt extends knee
- positive finding: apin over lat fem condyle at 30 degrees flex
Craig's test - how?
- pt prone, flex knee to 90 degrees
- palpate trochanter and put it in the most lateral position, parallel to the table
- hold it there while measuring angle of antiversion - should be 8-15 degrees
Craig's test - how to do the goniometry
- static arm (numberless) vertical
- moving arm - in line w tibial crest
- pivot - on femur by knee
indications of hip labrum tear or DJD/OA
- pain during sitting (tear is pinched)
- clicking or popping during gait, squatting, or other activities
- click during PROM (bc labrum is inert/noncontractile, PROM can test it)
Hip Scour Test aka quadrant test - how?
- pt supine w flexed hip and knee
- PT puts pressure on the knee going down thru femur while moving the le in an arc from IR to ER (start in add, flex, IR --> ER, flex, abd)
Hip Scour Test - tests what?
if there's pain or aprehension as PT moves pt thru the arc it indicates labral pain, or arthritis/OA, or according to one site, some kind of hip pathology
Anterior Labral Test aka FADDIR - how?
- pt is supine w hip in full flexion
- PT moves the femur from flex/ER/abd --> ext/IR/add (ext = leg is almost straight down on table) *no compression
- PT's hands are on distal femur by knee and craddling ankle
- FADDIR = Flexion ADDuction IR
Anterior Labral Test pos finding? indicates what?
- pos finding: the symptomatic pain, w/wo click
- indicates: tears in the hip labrum on the anterior and medial portions of the hip joint
Posterior Hip Labrum test - how?
- pt prone,
- PT's hands: one stabilizing ipsilat hip, one under knee lifting leg
- action: raise legso hip is just short of full ext w some ER (yr angling the pt so the foot goes medially)
Posterior Hip Labrum Test - indicates what? when might this happen?
- pain indicates post. labral tear
- it's rare - can happen in a car accident if pt's legs were crossed and hit the dashboard
Kellgren & Lawrence scale for radiographs
- 0 = clean
- 1 = possible narrowing or osteophytes
- 2 = deff narrowing w osteophytes or sclerosis
- 3 = marked narrowing, some osteophytes, some sclerosis, maybe a cyst
- 4 = gross loss of joint space, cysts, marked deformity of head
3+4 are candidates for hip replacement
x-rays are the gold standard for dx of OA, but there's this list of 5 symptoms, where if you have 3/5 you have 68% probability of OA, and 4/5 gives 91%. What are the 5?
- 1. self reported squatting as aggravating
- 2. active hip flexion causing lateral hip pain
- 3. scour test with adduction causing lateral hip or groin pain (or labral tear or DJD)
- 4. active hip extension causin pain
- 5. passive internal rotation </=25 degrees
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