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Examination of Hip Joint in a Child
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Nirmal Raj Gopinathan, Reet Mukopadhya, Karthick Rangasamy, Ramesh Kumar Sen
Patrick’s test is a provocative indirect stress test for the assessment of inflammation of the sacroiliac joint. It is known by the acronym FABER, which stands for flexion, abduction, and external rotation, resulting in a figure of 4 position. The limb on the side of examination is gradually positioned into the figure of 4 position. The ankle of the side to be tested rests on the opposite thigh proximal to the knee joint. The examiner presses down on the knee with counterpressure applied on the contralateral ASIS using the other hand (Figure 9.30). If the patient experiences posterior hip pain, sacroiliitis must be suspected. Remember, an arthritic hip or an iliopsoas pathology might produce an anterior groin pain, which should be differentiated from the one resulting from sacroiliitis.
Hip Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
While one positive test raises suspicion, three or more positive tests would confirm the sacroiliac joint as a source of the lumbar pain.58Seated flexion test (or Piedallu’s sign): The patient is seated with the feet flat on the ground; the examiner sits or stands behind the patient, then locates the patient’s iliac crest and rests the thumbs on it. Ask the patient to flex the back; the positive result presents when the affected side moves the thumb upward.FABER test (Patrick’s test): The patient lies supine, the tested leg is placed into flexion, abduction, and external rotation, and the ankle is resting on the contralateral thigh proximal to the knee. While stabilizing the opposite side of the pelvis at the anterior superior iliac spine, an external rotation, abduction, and posterior force are then lightly applied to the ipsilateral knee until the end of range of motion is achieved.The test result is positive when there is reproducing pain at the sacroiliac joint or the joint’s range of movement is limited.59Compression test:The patient lies on their side: The examiner stands behind the patient with the arms extended and hands overlapped over the upper part of the patient’s iliac crest and exerts a downward force toward the floor. Increased pain in the sacroiliac joints indicates a positive sign.60Distraction: The patient lies supine with the hands placed at the low back.The examiner crosses the arms with elbows straightened and places the hands on the anterior and medial aspects of the patient’s left and right Anterior Superior Iliac Spine (ASIS).Slowly and steadily presses both hands posteriorly (downward pressure).Yaoman’s test: The patient lies prone.The examiner flexes the patient’s test knee to 90 degrees and then hyperextends the same hip.The positive result is indicated by increasing pain localized to the sacroiliac joints; this indicated the pathology of the anterior sacroiliac ligaments.61
Greater trochanteric pain syndrome: predicting who will respond to a local glucocorticoid injection
Published in Scandinavian Journal of Rheumatology, 2021
M Jarlborg, DS Courvoisier, A Faundez, L Brulhart, A Finckh, MJ Nissen, S Genevay
Based on a literature review, we combined the three clinical tests with the highest reported accuracy for a diagnosis of GTPS, namely the Lequesne test (13), Patrick’s test (11), and the 30-second single-leg stance test (13). The Lequesne test is considered to be positive if LHP occurs with resisted external derotation. Patrick’s test is performed by placing the hip in flexion, abduction, and external rotation, and it is considered positive when it elicits LHP. The 30-second single-leg stance test is positive when typical LHP in the weight-bearing leg occurs within 30 s. Patients were considered to have a positive triple test if all three of these tests were positive, with the remaining patients having a negative triple test.