Oklahoma Sports Science & Orthopaedics, Oklahoma City, Oklahoma 73118, USA.
Arthroscopy. 2010 Feb;26(2):161-72. doi: 10.1016/j.arthro.2009.07.015.
The purpose of this study was to systematically evaluate the technique and tests used in the physical examination of the adult hip performed by multiple clinicians who regularly treat patients with hip problems and identify common physical examination patterns.
The subjects included 5 men and 6 women with a mean age (+/-SD) of 29.8 +/- 9.4 years. They underwent physical examination of the hip by 6 hip specialists with a strong interest in hip-related problems. All examiners were blind to patient radiographs and diagnoses. Patient examinations were video recorded and reviewed.
It was determined that 18 tests were most frequently performed (>or=40%) by the examiners, 3 standing, 11 supine, 3 lateral, and 1 prone. Of the most frequently performed tests, 10 were performed more than 50% of the time. The tests performed in the supine position were as follows: flexion range of motion (ROM) (percentage of use, 98%), flexion internal rotation ROM (98%), flexion external rotation ROM (86%), passive supine rotation test (76%), flexion/adduction/internal rotation test (70%), straight leg raise against resistance test (61%), and flexion/abduction/external rotation test (52%). The tests performed in the standing position were the gait test (86%) and the single-leg stance phase test (77%). The 1 test in the prone position was the femoral anteversion test (58%).
There are variations in the testing that hip specialists perform to examine and evaluate their patients, but there is enough commonality to form the basis to recommend a battery of physical examination maneuvers that should be considered for use in evaluating the hip.
Patients presenting with groin, abdominal, back, and/or hip pain need to have a basic examination to ensure that the hip is not overlooked. A comprehensive physical examination of the hip will benefit the patient and the physician and serve as the foundation for future multicenter clinical studies.
本研究的目的是系统地评估多位经常治疗髋部问题患者的临床医生对成人髋关节进行体格检查时所使用的技术和检查方法，并确定常见的体格检查模式。
本研究共纳入 5 名男性和 6 名女性患者，平均年龄（+/-SD）为 29.8 +/- 9.4 岁。6 位对髋部问题有浓厚兴趣的髋部专家对这些患者进行了髋关节体格检查。所有检查者均对患者的影像学检查结果和诊断不知情。对患者的体格检查进行了录像并进行了回顾。
确定了 18 项检查是检查者最常进行的 (>or=40%)，其中 3 项为站立位检查，11 项为仰卧位检查，3 项为侧卧位检查，1 项为俯卧位检查。在最常进行的检查中，有 10 项检查的使用率超过 50%。仰卧位时进行的检查包括：屈曲活动度（ROM）（使用率，98%）、屈曲内旋 ROM（98%）、屈曲外旋 ROM（86%）、仰卧位被动旋转试验（76%）、屈曲/内收/内旋试验（70%）、直腿抬高抗阻力试验（61%）和屈曲/外展/外旋试验（52%）。站立位时进行的检查是步态检查（86%）和单腿站立阶段检查（77%）。俯卧位时进行的 1 项检查是股前倾角试验（58%）。
髋部专家在进行检查和评估患者时存在检查方法的差异，但仍存在足够的共性，可以为推荐一组应考虑用于评估髋关节的体格检查操作奠定基础。
出现腹股沟、腹部、背部和/或髋部疼痛的患者需要进行基本检查以确保不遗漏髋关节的问题。对髋关节进行全面的体格检查将使患者和医生受益，并为未来的多中心临床研究奠定基础。
