Merck Manual

Please confirm that you are a health care professional

Loading

Evaluation of the Hip

By

Alexandra Villa-Forte

, MD, MPH, Cleveland Clinic

Last full review/revision Feb 2020| Content last modified Feb 2020
Click here for Patient Education
Topic Resources

An evaluation of the hip includes a physical examination and sometimes arthrocentesis. (See also Evaluation of the Patient With Joint Symptoms.)

Physical Examination of the Hip

Examination begins with gait evaluation. A limp is common among patients with significant hip arthritis and may be caused by any of the following:

  • Pain

  • Leg shortening

  • Flexion contracture

  • Muscle weakness

  • Knee problems

Loss of internal rotation (an early change in hip osteoarthritis or any hip synovitis), flexion, extension, or abduction can usually be demonstrated. Placement of one hand on the patient’s iliac crest detects pelvic movement that might be mistaken for hip movement. Flexion contracture can be identified by attempting leg extension with the opposite hip maximally flexed to stabilize the pelvis. Tenderness over the femoral greater trochanter suggests bursitis (which is extra-articular) rather than an intra-articular disorder. Pain with passive range of motion (assessed by internal and external rotation with the patient supine and the hip and knee flexed to 90°) suggests intra-articular origin. However, patients may have simultaneous intra-articular and extra-articular disorders.

Arthrocentesis of the Hip

Arthrocentesis of the hip is usually done using ultrasound guidance by an orthopedic specialist or an interventional radiologist and is not discussed here.

Click here for Patient Education
NOTE: This is the Professional Version. CONSUMERS: Click here for the Consumer Version
Professionals also read

Also of Interest

Videos

View All
How to Examine the Foot
Video
How to Examine the Foot
3D Models
View All
Herniated Nucleus Pulposus
3D Model
Herniated Nucleus Pulposus

SOCIAL MEDIA

TOP