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The psoas sign, also known as Cope's sign (or Cope's psoas test [1]) or Obraztsova's sign, [2] is a medical sign that indicates irritation to the iliopsoas group of hip flexors in the abdomen, and consequently indicates that the inflamed appendix is retrocaecal in orientation (as the iliopsoas muscle is retroperitoneal).
However, in the patient with a normal hip joint, a positive test is a good indicator of psoas hypertonicity. [2] Other signs from the Thomas test: opposite/ contralateral hip flexes without knee extension- tight iliopsoas; hip abducts during the test- tight tensor fasciae latae; knee extension occurs- tight rectus femoris
Patrick's test or FABER test is performed to evaluate pathology of the hip joint or the sacroiliac joint. [1] The test is performed by having the tested leg flexed and the thigh abducted and externally rotated. If pain is elicited on the ipsilateral side anteriorly, it is suggestive of a hip joint
Position – for most of the exam the patient should be supine and the bed or examination table should be flat. The patient's hands should remain at their sides with the head resting on a pillow. The knees and hips should be in the anatomical position (knee extended, hip neither flexed nor extended). Lighting – adjusted so that it is ideal.
The examiner internally rotates the hip by moving the patient's ankle away from the patient's body while allowing the knee to move only inward. This is flexion and internal rotation of the hip. In the clinical context, it is performed when acute appendicitis is suspected. In this condition, the appendix becomes inflamed and enlarged.
The Ober test is used in physical examination to identify tightness of the iliotibial band (iliotibial band syndrome). During the test, the patient lies on his/her side with the unaffected leg on the bottom with their shoulder and pelvis in line. The lower hip and knee can be in a flexed position to take out any lordosis of the lumbar spine. [1]
The hip joint is classified as a ball and socket joint. This type of synovial joint allows for multidirectional movement and rotation. There are two bones that make up the hip joint and create an articulation between the femur and pelvis. This articulation connects the axial skeleton with the lower extremity.
Involuntary extension of the "normal" leg occurs when flexing the contralateral leg against resistance. To perform the test, the examiner should hold one hand under the heel of the "normal" limb and ask the patient to flex the contralateral hip against resistance (while the patient is supine), asking the patient to keep the weak leg straight while raising it.