The Hip Exam Basics

Thomas Test

  • Active

  • Tests for hip flexor injury and flexibility

  • Technique

    • Patient supine on examination table with buttocks at the edge of the end of the table

    • Patient hugs both knees into chest

    • Continuing to grasp the affected extremity knee, the unaffected leg is slowly extended fully

    • Continuing to grasp the unaffected extremity knee, the affected leg is slowly extended​

    • A positive result occurs when the maneuver elicits symptoms/pain in the anterior hip/thigh, or the thigh does not parallel or extend beyond parallel, when assessing for flexibility 

    • A negative result is when there is no pain with the maneuver, when evaluating for injury, or the thigh extends past parallel when assessing for flexibility

Trendelenburg Test

  • Active

  • Tests for gluteus medius weakness

  • Technique

    • Patient standing

    • The unaffected hip and knee are actively flexed, leaving the patient standing on the affected leg

    • A positive test occurs when the unaffected hip drops and the affected hip juts out or the patient leans to the unaffected side

    • A negative result occurs when the patient is able to stand on the affected leg and the hips stay parallel and the body straight upright

Ober Test

  • Passive

  • Tests for iliotibial band syndrome/flexibility

  • Technique

    • Patient side-lying facing away from the examiner with the affected extremity up, with knees bent

    • Examiner grasps the affected leg knee and ankle, and slowly flexes the hip, abducts and extends the hip in a fluid motion, while stabilizing the patient's hip with your hip, preventing it from rolling back 

    • A positive result occurs when the maneuver elicits symptoms/pain along the lateral hip/thigh, or the thigh does not drop to the level of the opposite knee

    • A negative result is when there is no pain with the maneuver, when evaluating for injury, or the thigh drops to the level of the opposite knee

 

FABER Test

  • Passive

  • Tests for labral tear, femora-acetabular impingement, sacroiliac joint dysfunction

  • Technique

    • Patient supine affected hip Flexed, ABducted, Externally Rotated.  Essentially, affected leg ankle crossed over the unaffected at the knee creating a "figure 4"

    • Examiner presses one hand on the flexed knee and pressing downward, while the other presses the pelvis att the opposite ASIS

    • A positive result occurs when the maneuver elicits symptoms/pain in the hip or SI joint

    • A negative result is when there is no pain with the maneuver

Stinchfield Test

  • Active

  • Tests for intra-articular hip pathology (osteoarthritis, labral tear, etc.)

  • Technique

    • Patient supine and performs an active straight leg raise with the affected leg

    • Examiner presses down on the leg when it is raised

    • A positive result occurs when the maneuver elicits symptoms/pain in the hip

    • A negative result is when there is no pain with the maneuver

"C" sign

  • When a patient describes the location of his/her hip pain by grasping the hip with the thumb and finger forming "C" 

  • Has correlation with labral tear/femoro-acetabular impingement