Hip Pathology Special Tests

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

In the context of Bryant's Triangle test for hip pathology, a positive test, indicated by a difference in measurements between sides, suggests which specific condition?

Coxa vara/hip dislocation (correct)
Iliopsoas tendonitis
Coxa valga
Greater trochanteric bursitis

Which of the following scenarios would yield a positive finding in the Flexion ADDUCTION Test, indicative of hip pathology?

Full, pain-free range of motion during hip adduction with the hip flexed in a supine position.
Increased range of motion during passive hip adduction compared to the unaffected side.
Limited range of motion and pain during hip adduction with the hip flexed in a supine position. (correct)
Limited range of motion and pain during hip adduction with the hip flexed in a prone position.

During the Mc Carthy Hip Extension Sign assessment, which specific combination of hip movements, when coupled with pain reproduction, is most indicative of labral pathology?

Passive hip extension with lateral rotation. (correct)
Passive hip flexion with internal rotation.
Passive hip flexion with adduction.
Passive hip abduction with medial rotation.

In the Trendelenburg test, if a patient stands on their right leg and the left side of their pelvis drops, which of the following interpretations is most accurate, assuming the test is performed correctly?

Weakness of the right gluteus medius on the stance leg. (B) Signup and view all the answers

During the Patrick's Test (FABER), the examiner passively lowers the test leg towards the table. Which finding is MOST indicative of SI joint involvement rather than hip pathology?

The test leg's knee remains higher than the opposite leg accompanied by pain localized at the SI joint. (B) Signup and view all the answers

In the Sign of the Buttock test, how does differentiating between hip pathology and hamstring tightness rely on knee flexion, and what specific finding confirms hip involvement?

Hamstring tightness is indicated if SLR improves with knee flexion, whereas hip pathology remains unaffected. (B) Signup and view all the answers

When performing the Thomas Test, identify the MOST reliable indicator of iliopsoas tightness versus rectus femoris tightness, and explain why this distinction is crucial for accurate diagnosis.

Observation of hip flexion indicates iliopsoas tightness, while knee extension indicates rectus femoris tightness; crucial for guiding specific muscle-release techniques. (B) Signup and view all the answers

During the Kendall Test for rectus femoris contracture, what specific compensatory movement observed in the contralateral limb would strongly suggest a positive finding, and what underlying biomechanical principle explains this?

Contralateral knee extension, due to the rectus femoris pulling on the acetabulum which affects the contralateral leg. (D) Signup and view all the answers

In Ely's Test for rectus femoris contracture, what is the primary biomechanical reason for observing ipsilateral hip flexion when passively flexing the knee, assuming no neurological involvement?

The rectus femoris, acting as a biarticular muscle, pulls the pelvis into anterior tilt when shortened. (D) Signup and view all the answers

During the 90-90 Straight Leg Raise test for hamstring tightness, what is the MOST critical procedural detail to ensure accurate assessment, and how does this detail specifically isolate hamstring length?

Ensure the pelvis is stabilized to prevent posterior pelvic tilt. (A) Signup and view all the answers

In the context of the Back-Saver Sit-and-Reach test for hamstring flexibility, what confounding factor, unrelated to hamstring length, could MOST SIGNIFICANTLY influence a patient's ability to reach their toes, thereby affecting the test's validity?

Sciatic nerve tension due to underlying disc pathology. (A) Signup and view all the answers

During the Tripod Sign assessment for hamstring tightness, what specific biomechanical adaptation involving the trunk indicates a positive test, and what is the underlying rationale for this compensatory movement?

Trunk backward leaning, to reduce the degree of hip flexion required during knee extension. (C) Signup and view all the answers

In Ober's Test, if the upper leg remains in abduction after being passively adducted towards the table, what other concurrent finding (beyond just abduction) would MOST STRONGLY indicate true TFL/ITB contracture rather than other potential causes of limited adduction?

A firm end-feel with no further adduction possible, even with increased force. (D) Signup and view all the answers

During the Noble Compression Test for ITB friction syndrome, at what degree of knee flexion is pain provocation considered the MOST indicative of a positive test, and what specific anatomical structure is being stressed at that angle?

30 degrees; the ITB compressing against the lateral femoral epicondyle (B) Signup and view all the answers

In the Piriformis Test, what specific combination of hip position and applied force is used to provoke symptoms, and what neurovascular structure is being directly stressed by this maneuver?

Hip flexion, adduction, and internal rotation, compressing the sciatic nerve. (C) Signup and view all the answers

During Phelp's Test for gracilis contracture, what specific alteration in hip abduction range of motion with knee flexion, compared to hip abduction with knee extension, indicates a positive test, and why does this change occur?

Increased hip abduction with knee flexion due to relaxation of the biarticular gracilis muscle. (C) Signup and view all the answers

In the Modified Thomas Test, what specific observation regarding the position of the test leg during active hip extension provides the MOST direct evidence of iliopsoas tightness, assuming the rectus femoris length is normal?

The test leg is unable to achieve full hip extension and remains in a flexed position. (A) Signup and view all the answers

During Ortolani's test, what is the distinct sensation that indicates a positive sign for developmental dysplasia of the hip (DDH), and which specific anatomical event causes this sensation?

A palpable 'click' as the femoral head reduces into the acetabulum. (A) Signup and view all the answers

During Barlow's test, what specific maneuver is performed after hip flexion and adduction to assess for hip instability, and what is the significance of a palpable 'clunk' heard or felt during the maneuver?

Applying a posterior force to the greater trochanter while abducting the hip, indicating a subluxatable hip. (A) Signup and view all the answers

What fundamental biomechanical difference distinguishes a positive Galeazzi sign from a positive Telescoping (Piston) sign in the assessment of developmental dysplasia of the hip (DDH) in infants?

Galeazzi sign indicates unilateral hip dislocation due to femoral shortening, while Telescoping sign indicates ligamentous laxity causing instability. (D) Signup and view all the answers

In the context of assessing for hip dislocation (CDH/DDH), what specific anatomical structure is primarily evaluated during hip abduction when performing the Abduction Test/Hart Sign, and how does asymmetry in this structure suggest a positive finding?

The gluteal folds, where asymmetry suggests hip subluxation or dislocation. (D) Signup and view all the answers

When performing the Valgus Stress Test on the knee, what is the MOST accurate biomechanical rationale for assessing the knee at both 0 and 30 degrees of flexion?

To differentiate between superficial and deep medial collateral ligament (MCL) fiber involvement. (A) Signup and view all the answers

During the Varus Stress Test on the knee, what specific finding would lead you to suspect a combined injury involving both the LCL and posterolateral corner structures, rather than an isolated LCL tear?

Increased varus laxity at both 0 and 30 degrees of knee flexion with no clear end-feel. (B) Signup and view all the answers

What is the MOST critical procedural element to ensure accuracy in the Lachman test, and how will its omission affect the interpretation of the test results?

Stabilizing the femur to isolate tibial translation. (D) Signup and view all the answers

What is the clinical significance of the difference in anterior tibial translation between the Drawer Test performed at 90 degrees of hip flexion versus the Posterior Sag Sign, regarding the structures being evaluated, and how would you interpret these findings?

The Drawer Test assesses for the combined anterior instability and posterolateral corner integrity and Poster Sag tests tests PCL more specifically. (C) Signup and view all the answers

What distinct advantage does the Godfrey Test offer over the traditional Posterior Drawer Test in assessing PCL integrity, particularly in the acute phase following injury?

The Godfrey Test reduces the risk of further displacing a recently ruptured PCL during examination. (C) Signup and view all the answers

In rotatory instability testing (Slocum and Hughston tests), what is the KEY distinction in patient positioning and examiner's manipulation that differentiates the Slocum test for anterolateral rotatory instability (ALRI) from the Hughston test for posterolateral rotatory instability (PLRI)?

They differ in the degree of knee flexion used during the application of stress and rotation. (B) Signup and view all the answers

In the context of joint effusion assessment using the patellar tap test, what underlying physiological principle explains the 'floating patella' sign observed with significant swelling?

Increased intra-articular pressure elevates the patella away from the femoral groove. (A) Signup and view all the answers

During the Apley test, what is the MOST important distinction between the distraction and compression components, regarding the structures they target, and how do their results guide clinical decision-making?

Distraction targets ligamentous structures, while compression targets meniscal structures, guiding decisions on surgical versus conservative management. (B) Signup and view all the answers

In performing the McMurray test, what is the primary biomechanical rationale for combining tibial rotation with knee flexion and extension to assess meniscal tears, rather than simply flexing and extending the knee?

To place the menisci under torsional stress, accentuating potential tears. (A) Signup and view all the answers

What is the MOST specific clinical sign observed during the Bounce Home Test that differentiates a torn meniscus from other intra-articular knee pathologies?

A rubbery or springy block preventing full knee extension. (A) Signup and view all the answers

In the context of the Too Many Toes sign, what specific anatomical plane deformity does this sign primarily indicate with respect to the foot and ankle, and what is the underlying mechanical cause?

Transverse plane deformity due to abduction of the forefoot relative to the rearfoot. (C) Signup and view all the answers

What is the crucial distinction in differentiating an ATFL tear from a syndesmosis injury based on the Anterior Drawer Test of the ankle, considering the subtle biomechanical nuances?

The location of pain and the amount of anterior talar translation differentiates an ATFL tear from a syndesmosis injury, the latter having increased translation. (B) Signup and view all the answers

During the Talar Tilt test, why is it essential to assess both inversion and eversion stress, and how do the findings from each direction contribute to differential diagnosis of lateral versus medial ankle ligament injuries?

Inversion assesses the calcaneofibular ligament (CFL), while eversion assesses the Deltoid ligament. (C) Signup and view all the answers

In the Talar Neutral Position assessment, what is the physiological basis for using palpation of the talar head as a guide to determine the subtalar joint's neutral position, considering the complex arthrokinematics of the foot?

Palpation of the talar head during pronation and supination determines when the talus is equally congruent within the mortise. (D) Signup and view all the answers

Flashcards

Newton's Line

An imaginary line between the ASIS and Ischial Tuberosity used to assess hip pathology.

Bryant's Triangle

Triangle used to assess coxa vara/hip dislocation by dropping a line from ASIS, palpating G Trochanter, and comparing sides.

Flexion ADDUCTION Test

Test involving supine position, hip flexion, passive hip adduction, and assessing for limitations.

Mc Carthy Hip Extension Sign

Test involves supine position, hip flexion, and passive hip extension with rotation to reproduce pain.