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S.Sattari,MD Pelvis, Hip, and Thigh examination. pelvic ring protects vital internal structures.

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Presentation on theme: "S.Sattari,MD Pelvis, Hip, and Thigh examination. pelvic ring protects vital internal structures."— Presentation transcript:

1 S.Sattari,MD Pelvis, Hip, and Thigh examination

2 pelvic ring protects vital internal structures

3 A stable central base for human locomotion A foundation for the spine and upper body A point of origin or insertion for many muscles of the thorax, the hip, and the thigh

4 ball-and-socket design considerable motion in three planes second only to the shoulder in the range and complexity of its potential motion.

5 A. iliac crest; B. anterior superior iliac spine; C, pubic symphysis; D, pubic tubercle; E sartorius; F, lateral femoral cutaneous nerve; G. femoral artery; H, tensor fascia lata;I, anterior interior iliac spine; J, hip joint; K, lesser trochanter. 2 cm lateral and 2 cm distal groin pain

6 A, rectus femoris; B, vastus medialis; C, vastus lateralis; D, iliotibial tract; E, adductor longus; F gracilis; G, sartorius. meralgia paresthetica

7 A, iliac crest; B, anterior superior iliac spine; C. posterior superior iliac spine; D, gluteus medius; E, tensor fascia lata; F. gluteus maximus; G. greater trochanter. Nelaton's line

8 A,iliac crest;B, posterior superior iliac spine; C, sacroiliac joint; D. gluteus maximus; E, sacrum; F, coccyx; G, ischial tuberosity; H, greater trochanter; I, piriformis; J, quadratus femoris; K, gluteal fold; L, sciatic notch. 167

9 A, biceps femons; B. semitendinosus; C semimembranosus

10 ALIGNMENT

11 Pelvic Obliquity

12 True leg length discrepancy Functional, or apparent, leg length discrepancy

13 True Versus Functional Leg Length Discrepancy In a true leg length discrepancy, the actual length of the patient's two lower limbs, when measured from the femoral heads to the plantar surfaces of the feet, is different. Causes: one of the bones of the lower limb actually being shorter or longer than its counterpart on the other side: varus or valgus deformities of the femoral neck congenital anomalies of the femur or tibia growth disturbances of the femur or tibia..

14 Functional leg length discrepancy Apparent leg length discrepancy, the patient's two lower limbs are identical in length; however, other factors, such as joint or muscle contractures, cause one of the lower limbs to function as if it were shorter or longer than the other. causes : contractures at the lumbosacral junction due to scoliosis or other causes posttraumatic deformities of the pelvis abduction or adduction contractures of the hip or flexion contracture of the knee

15 Measuring a true leg length discrepancy Measuring a functional leg length discrepancy

16 functional limb length discrepancy

17 True leg length Comparing femoral lengths

18 Comparing tibial lengths

19 GAIT

20

21 Trendelenburg's Gait not quite strong enough

22 Abductor limp painful hip joint osteoarthritis of the hip

23 Range Of Motion

24 Thomas Test A, Preparation. B, Assessing extension of the right hip. C, Demonstrating flexion contracture of the right hip (arrow). D, Assessing flexion of the right hip

25 Special Tests TESTS FOR JOINT CONTRACTURES

26 Ober's Test

27 Ely's test

28 Tripod sign

29 SCREENING TESTS FOR TENDINITIS

30 piriformis syndrome piriformis test &

31 Patrick's Test FABER test: Flexion-ABduction External Rotation

32 Gaenslen's Test

33 Trendelenburg's test.


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