History and examination of hip including special clinical tests

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A Trendelenburg’s test is performed to assess the integrity of the abductor mechanism of the hip, which consists of fulcrum, lever arm and power.
The primary musculature involved is the gluteal musculature, including the gluteus medius and gluteus minimus muscles.
Any pathology of the fulcrum, load, effort, or the lever which binds all three will lead to a positive Trendelenburg test.

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QUESTION 1 OF 6

A 70-year-old lady is recruited on a long-term study to evaluate the outcome of a novel hip arthroplasty. She is extremely anxious in attending the hospital clinic due to the covid pandemic.
Which of the following outcome measures cannot be recorded by sending a questionnaire through post?

QUESTION ID: 1282

1. EQ5D (Euroqol 5D)
2. Harris Hip Score
3. Oxford hip score
4. SF36 (Short Form 36)
5. WOMAC score
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QUESTION 2 OF 6

71.A 19-year old ballet dancer presents with a snapping sensation in the groin region.
On clinical examination, which of the following manoeuvres will be most helpful in confirming the diagnosis?.

QUESTION ID: 2195

1. With the patient in the lateral position the hip is flexed to 45° and the knee to 90°. The pelvis is stabilised, and the flexed hip is adducted
2. With the patient in the lateral position, the hip is brought from flexion and adduction into extension and abduction
3. With the patient supine, the hip is brought from a position of flexion, abduction and external rotation into extension, adduction and internal
4. With the patient supine, the hip is flexed to 90°, then adducted and internally rotated
5. With the patient supine, the ipsilateral knee is flexed to 90° and the hip is then extended, adducted and externally rotated
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QUESTION 3 OF 6

97.These 2 boys are standing on their left legs.
Which statement would you consider most accurate?

Answer D- The boy on the right has abductor muscle weakness 3.png

QUESTION ID: 2237

1. Both boys have leg length discrepancies
2. The boy on the left has abductor muscle weakness
3. The boy on the right has a scoliosis
4. The boy on the right has abductor muscle weakness
5. The boy on the right has pes planus
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QUESTION 4 OF 6

42.During clinical examination you note a patient has a leg length discrepancy.
Which of the following is an apparent leg length discrepancy with the correct clinical findings?

QUESTION ID: 3238

1. Crowe IV dysplastic hip (superior subluxation) - positive Galeazzi test, asymmetrical Bryant’s triangle, Thomas test negative.
2. Hip arthrodesis – negative Galeazzi test, symmetrical Bryant’s triangle, Thomas test negative.
3. Hip fixed flexion deformity – Galeazzi test negative, asymmetrical Bryant’s triangle, Thomas test negative.
4. Previous distal femoral physeal injury - negative Galeazzi test, symmetrical Bryant’s triangle, Thomas test negative.
5. Previous tibia fracture malunion - positive Galeazzi test, asymmetrical Bryant’s triangle, Thomas test negative.
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QUESTION 5 OF 6

43.Which is not a cause of a positive Trendelenburg sign?

QUESTION ID: 3239

1. Hip abductor tendinopathy
2. Hip arthritis
3. L2 root lesion
4. Post-operative superior gluteal nerve palsy
5. Total hip arthroplasty with reduced offset
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QUESTION 6 OF 6

51.When examining for contractures around the hip, which eponymous test is performed by lying the patient supine, and abducting the affected hip as far as possible, then assessing if more abduction is possible when the knee is flexed?

QUESTION ID: 3247

1. Bryant’s
2. Ely’s
3. Ober’s
4. Patrick’s
5. Phelp’s
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