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Outer hip pain might be caused by one of the gluteal muscles in the hip or tightness in the long band of connective tissue that runs down the leg, called the iliotibial (IT) band.
The examiner holds the patient's right thigh and passively extends the hip. Alternatively, the patient lies on their back, and the examiner asks the patient to actively flex the right hip against the examiner's hand. [3] If abdominal pain results, it is a "positive psoas sign".
Kaltenborn test or Hip Lag Sign for hip abductor function. To perform the Kaltenborn test, the patient has to lie in a lateral, neutral position with the affected leg being on top. The examiner then positions one arm under this leg to have good hold and control over the relaxed extremity, whereas the other hand stabilizes the pelvis.
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.
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
Damage to the motor nerve supply of the lateral gluteal muscles (gluteus medius muscle and gluteus minimus muscle) Polio involving L5 (foot drop may also be seen because L5 innervates the tibialis anterior muscle). [3] Damage to the superior gluteal nerve. Temporary or permanent weakness of the lateral glutei Tendinitis. Penetrating injury.
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Physical exam should also involve assessing passive internal rotation of the hip during flexion, as range of motion is reduced in proportion to the size of a cam lesion. [10] Flexing the hip to 90 degrees, adducting, and internally rotating the hip, known as the FADDIR test, should also be performed. [10] It is positive when it causes pain.