Hip Examination

Consider asking which side is the patient's kicking foot if they are a sportsperson

Check for general lower leg alignment, scars or sinuses, asymmetry between sides

A leg may look short without actually being short e.g. A person with a fixed adduction of the right hip had to hitch up his pelvis in order to uncross his legs making the right leg appear shorter

Use back of hands and compare sides

Examiner places fist between knees at 60 degrees hip and knee flexion and patient adducts bilaterally against the fist (suggestive of osteitis pubis if positive)

Patient stands unassisted on each leg in turn and lifts the other leg by bending the knee. Normally the weight-bearing hip is held stable by the abductors and the pelvis rises on the unsupported side; if the hip is unstable or very painful the pelvis drops on the unsupported side. Positive Trendelenburg seen with hip subluxation/dislocation, hip abductor weakness, shortening of femoral neck

Used to unmask fixed flexion deformity hidden by excessive lumbar lordosis. Both hips are flexed simultaneously to their limit and holding the non-test knee in this position the test limb is lowered gently. If there is a flexion deformity at the hip the knee will not rest on the couch