REIDER PART 2 34
194 Chapter 5_Pelvis, Hip, and Thigh
Figurę 5-57. Ely’s test. A, Norma!. B, Abnormal (tight rectus femoris).
Figurę 5-58. Tripod sign. A, Normal. B, Abnormal.
hip. This iiwoluntary hip extension causes the patients trunk to fali backward, often to the point that the patient will need to support himself or herself with outstretched hands (Fig. 5-58B). Sciatic nerve irritation causes a simi-lar response and must be considcrcd if this test is positive. If the tripod sign is due to tight hamstrings alone, nerve root tension signs such as Lasegue s sign and the bow-string sign should be absent. Tests for sciatica are dis-cussed in Chapter 9, Lumbar Spine.
Phelps' Test. The Phelps test is designed to detect con-tractures of the gracilis muscle, which originates from the pubis and ischium and inserts into the pes anscrinus on the proximal medial tibia. To perform it, the patient is placed in the prone position on the examining table with the knces fully extended. The cxaminer then pas-sively abducts the patients hips to the maximal degree possible (Fig. 5-59A). The patients knees are then flexed, thereby relaxing tension in the gracilis muscles, and the examiner attempts to abduct the hips further (Fig. 5-59B). If the patient s hips are capable of further abduction when the knees are flexed, a significant gracilis contracture is present.
Screening Tests for Tendinitis As in other parts of the body, two generał types of tests can be used to screen for tendinitis about the hip. The first type of test consists of having the patient perform a resis-ted contraction of the suspected muscle-tendon unit to
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