A Practical Guide to Clinical Medicine
A comprehensive physical examination and clinical education site for medical students and other health care professionals
|Introduction||Breast Exam||Write Ups|
|History of Present Illness||Male Genital/Rectal Exam||The Oral Presentation|
|The Rest of the History||The Upper Extremities||Outpatient Clinics|
|Review of Systems||The Lower Extremities||Inpatient Medicine|
|Vital Signs||Musculo-Skeletal Exam||Clinical Decision Making|
|The Eye Exam||The Mental Status Exam||Physical Exam Lecture Series|
|Head and Neck Exam||The Neurological Exam||A Few Thoughts|
|The Lung Exam||Physical Exam Check Lists||Commonly Used Abbreviations|
|Cardiovascular Exam||Medical Links||References|
|Exam of the Abdomen|
The "daVinci Anatomy Icon" denotes a link to related gross anatomy pictures.
Function and Anatomy: The hip is a ball and socket type joint, formed by the articulation of the head of the femur with the pelvis. Normal range of motion includes: abduction 45 degrees, adduction 20-30 degrees, flexion 135 degrees, extension 30 degrees, internal and external rotation. Hip pathology can cause symptoms anywhere around the joint, though frequently pain is anterior and radiates to the groin region. Additionally, pathology outside of the hip can be referred to this region. History and exam obviously help in making these distinctions.
A few common problems are described below:
Presentation and anatomy: Patients usually report pain with weight bearing and ambulation. Symptoms progress slowly over time (ie years) with pain precipitated by less activity (ie shorter distances walked) as the disease worsens. This tends to occur in patients > 50, as age increases the risk of wear and tear on the joint. Obesity, which chronically increases the load and stress that the joint must bear, is a major risk factor. There may also be a history of significant antecedent trauma that damaged the joint, "setting it up" for degenerative changes over time.
Anatomy and function: The troachanteric bursa overlies the greater trochanter of the femur. When it becomes inflamed, patient's report vague hip pain, focused on the lateral area of the joint. Symptoms tend to get worse with walking.
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