REIDER PART 239

C D

Figurę 5-67, cont'd. C, Abnormal, with drooping pelvis. D, Abnormal, with compensation.

TABLE 5-1

PHYSICAL FINDINGS IN COMMON CONDITIONS OF THE PELVIS, THE HIP,

AND THE THIGH

Osteoarthritis of the Hip

Tenderness over the anterior hip capsule

Pain reproduced by passive rotation of the hip

Restricted rangę of motion (rotation is usually first affected)

Pain reproduced by Stinchfield’s test Abductor limp (morę severe cases)

Functional leg length discrepancy (if abduction contracture has developed)

Posterior Dislocation of the Hip

Hip held in position of flexion, internal rotation, and adduction Possible concomitant sciatic nerve injury (weakness of dorsiflexion and plantar flexion of the ankle)

Anterior Dislocation of the Hip

Hip held in position of mild flexion, abduction, and external rotation Possible associated femoral nerve injury (quadriceps weakness)

Hip Fracture

Tenderness over the anterior hip capsule or the intertrochanteric region Limb externally rotated and shortened (displaced fractures)

Stinchfield’s test pa infuł or cannot be performed

Pelvis Fracture or Disruption

Tenderness of the pubie symphysis, the iliac crest, or the sacroiliac joints Pain in response to pelvic compression tests (lateral pelvic compression test, anteroposterior pelvic compression test, pubie symphysis stress test) Pain with Patricks test or Gaenslens test (especially in the sacroiliac joint) Sacroiliac Joint Dysfunction Tenderness over the sacroiliac joint Pain reproduced by Patricks test or Gaenslens test Meralgia Paresthetica (Entrapment of Lateral Femoral Cutaneous Nerve)

Altered sensation over the anterolateral thigh

Symptoms reproduced by pressure or percussion just medial to the anterior superior iliac spine Piriformis Tendinitis

Tenderness to deep palpation near the hook of the greater trochanter Pain reproduced by piriformis test Gluteus Maximus Tendinitis

Tenderness near the gluteal fold at the inferior aspect of the gluteus maximus

Pain reproduced by Yeomans test

Gluteus Medius Tendinitis

Tenderness just proximal to the greater trochanter Pain reproduced by resisted abduction of the hip Trochanteric Bursitis

Tenderness over the lateral aspect of the greater trochanter Popping or crepitation felt with flexion-extension of the hip (occasionally)

Tight iliotibial tract revealed by Ober’s test (variable)

Quadriceps Strain or Contusion

Tenderness and swelling of the involved area of the quadriceps Weakness of quadriceps contraction

Restriction of knee flexion, especially when the hip is extended Palpable divot in the quadriceps (morę severe strains)

Warmth and Firmness in quadriceps (impending myositis ossificans)

Hamstring Strain

Localized tenderness and swelling at the site of injury Ecchymosis (frequently)

Restricted knee cxtension and straight leg raising Palpable divot in the injured hamstring (morę severe injuries) Abnormal tripod sign