Foveal Distraction Test

Prone

11. Ely's test

Examination

Assessment/association

Scours

Foveal distraction

Extension, abduction, external rotation Craig's test

Intra-articular pathology, internal pop/click Torn labrum

Hyperlaxity, high instability index Femoral anteversion

Examination

Assessment/association

Scours

Foveal distraction

Extension, abduction, external rotation Craig's test

Intra-articular pathology, internal pop/click Torn labrum

Hyperlaxity, high instability index Femoral anteversion

The physical examination test recommended for assessing any contracture of the rectus femoris muscle is Ely's test. This assessment is performed by flexing the knee and drawing the lower leg into the thigh. A negative test demonstrates full flexion of the knee to the thigh with no movement in the pelvis. A positive Ely's sign demonstrates that with flexion at the knee, the pelvis will tilt, raising the buttocks from the table.

The 11-point athletic hip examination can be effective in screening and evaluating patients who have hip pain, and can be helpful to direct further diagnostic studies (Table 9). A marcaine injection test may be necessary to distinguish between hip and back pathology. This and other auxiliary clinical tests may be helpful in further evaluation of the hip (Table 10). The majority of examinations that compose the 11-point athletic hip examination were developed over many years, before the pathomechanics were fully understood. Individuals using these tests and the tests that have been more recently developed could benefit from validation to determine their accuracy in the detection of the various types of hip pathology. A thorough systematic physical examination coupled with history is the best method to determine subsequent radiologic or diagnostic testing recommendations. As with any examination, practice and repetition are essential to gain an appreciation of what constitutes a normal as well as an abnormal exam. When used consistently and with practice, the 11-point athletic hip examination will help the examiner to formulate an accurate list of diagnostic possibilities and to determine what other diagnostic examinations or techniques may benefit the patient.

References

[1] Scopp JM, Moorman CT. The assessment of athletic hip injury. Clin Sports Med 2001; 20(4):647-59.

[2] American Orthopedic Society for Sports Medicine. Injuries to the pelvis, hip, and thigh. In: Griffin LY, editor. Orthopedic knowledge update. Rosemond (IL): Sports Medicine, American Academy of Orthopedic Surgeons; 1994. p. 239.

[3] Boyd KT, Peirce NS, Batt ME. Common hip injuries in sports. Sports Med 1997;24: 273-88.

[4] DeAngelis NA, Busconi BD. Assessment and differential diagnosis of the painful hip. Clin Orthop 2003;406:11-8.

[5] Kujala UM, Kaprio J, Sarna S. Osteoarthritis of weight-bearing joints of lower limbs in former elite male athletes. BMJ 1994;308:230-4.

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