IDENTIFICATION DATA

NAMEAGEGENDERADDRESS+TELEPHONE NUMBERREGISTRATION NUMBEROCCUPATIONPLACE OF OBSERVATIONDURATION OF OBSERVATION-

CASE DATA BASE

CHIEF COMPLAINT-

HISTORY OF PRESENT ILLNESS-

HISTORY OF PAST ILLNESS-

RELEVANT MEDICAL HISTORY-

FAMILY HISTORY-

SOCIAL HISTORY-

PERSONAL HISTORY-

OBSERVATIONPOSTUREANTERIOR VIEW LATERAL VIEW POSTERIOR VIEW

GAITWhether patient can attain weight bearing position and bears weight equally on both the legs?BALANCESYMMETRY OF THE LIMBSPRESENCE OF SHORTENING OF LEG OR ANY DEFORMITYCOLOR AND TEXTURE OF THE SKIN.ANY SCARS OR SKIN LEISON.PALPATIONSWELLING MUSCLE SPASM TEMPERATURE TENDERNESS

EXAMINATIONRANGE OF MOTION MEASUREMENT MOVEMENT

HIP FLEXIONHIP EXTENSIONHIP ABDUCTIONHIP ADDUCTIONHIP MEDIAL ROTATIONHIP LATERAL ROTATION-

ACTIVE (left-right)

PASSIVE (left-right)

INFERENCE:

MANUAL MUSCLE TESTING MUSCLES

HIP FLEXORSHIP EXTENSORSHIP ABDUCTORSHIP ADDUCTORSHIP MEDIAL ROTATORSHIP LATERAL ROTATORS-

RIGHT

LEFT

INFERENCE: REFLRXES AND CUTANEOUS DISTRIBUTION There are no reflexes around hip joint that can be easily evaluated. DERMATOMES L1- Anterior and lateral side of hip L2- Anterior thigh and posterior half lower back L3- Posterior half lower back FUNCTIONAL ACTIVE MOVEMENT Walk____ Run _____ Squat _____ Kneel______ PROVISIONAL DIAGNOSIS SPECIAL TESTSPATRICK (FABER) TEST TRENDELENBURG'S SIGN THOMAS TEST RECTUS FEMORIS TEST OBER'S TEST 90-90 STRAIGHT LEG RAISE TEST

jump____ hop _____ twist______ stair climbing______

TEST FOR LEG LENGHT

DIFFERENTIAL DIAGNOSISDIAGNOSTIC TESTSX-RAYSCT SCANMRIULTRASOUND-

DIAGNOSISTREATMENT PLANSHORT TERM GOALS:

LONG TERM GOALS:

PHYSIOTHERAPY TREATMENT:

ERGONOMIC ADVICE

HOME EXERCISE PROGRAMME

STUDENT THERAPIST

SUPERVISOR THERAPIST

ANNEXURE
SPECIAL TESTS 1. PATRIC(FABER) TESTPOSITION OF PATIENT- Supine lying POSITION OF THERAPISTS- At the side of the patient to be tested. PROCEDURE- Examiner places the patients test leg so that the foot of the test leg is on top of the knee of opposite leg,then slowly lowers the knee of the test leg toward examining table. FINDING- A negative test is indicated by the test leg's knee falling to the table or at least being parallel with the opposite leg. A positive test is indicated by the test leg's knee remaining above the opposite straight leg. INTERPRETATION- If positive, the test indicates that the hip joint may be affected, there may be iliopsoas spasm, or the sacroiliac joint may be affected. 2. TREDELENBURGS SIGNPOSITION OF PATIENT- Standing upright POSITION OF THE THERAPIST- In front of the patient PROCEDURE- Ask the patient to raise one leg in air, maintaining balance and without taking external help. FINDING- If the pelvis on the opposite side (nonstance side) drops when the patient stands on the affected leg, a positive test is indicated.. INTERPRETATION- If the pelvis drops on the opposite side, it indicates a weak gluteus medius or an unstable hip on the affected or stance side 3. THOMAS TESTPOSITION OF PATIENT-Supine lying POSITION OF THERAPIST- At the side(test leg) of the patient PROCEDURE- Examiner flexes one of the patients hip, bringing the knee to the chest to flatten out the lumbar spine and stablize pelvis and then patient holds the flexed hip against the chest. FINDING- Is positive if the non test leg of the patient rises off the table INTERPRETATION- A hip flexor of non test leg is either tight or in contracture state, and a muscle stretch end feel will be felt. 4. RECTUS FEMORIS TESTPOSITION OF THE PATIENT- The patient lies supine with the knees bent over the end or edge of the examining table. The patient flexes one knee onto the chest and holds it POSITION OF THE THERAPIST- At the side of the patients leg to be tested FINDING- The angle of the test knee should remain at 90 when the opposite knee is flexed to the chest, if the test leg extends any degree then this test is positive. INTERPRETATION- If positive (i.e., the test knee extends slightly), a spasm or contracture is probably present. 5. OBERS TESTPOSITION OF PATIENT- The patient is in the side lying position with the lower leg flexed at the hip and knee for stability. POSITION OF THE THERAPIST- At the side of the patient, at the side to be tested. PROCEDURE- The examiner then passively abducts and extends the patient's upper leg with the knee straight or flexed to 90, the examiner then slowly lowers the upper limb.

FINDING- If positive then the leg remains abducted and does not fall to the table. INTERPRETATION- A tightness or contracture is present in tensor fascia latae. 6. 90-90 STRAIGHT LEG RAISING TESTPOSITION OF PATIENT- Supine lying POSITION OF THE THERAPIST- At the side of the patient to be tested. PROCEDURE- The patient flexes both hips to 90 while the knees are bent. The patient then grasps behind the knees with both hands to stabilize the hips at 90 of flexion. The patient actively extends each knee in turn as much as possible FINDING- Normally, or if the hamstrings are tight, the end feel will be muscle stretch and knee extension should be with in 20 of full knee extension INTERPRETATION- Nerve root symptoms may also result, as this positioning is similar to the slump test done in supine lying instead of sitting. 7. TEST FOR LEG LENGHTTRUE SHOTENING POSITION OF PATIENT- Supine lying, 15-20 cm apart, legs parallel to each other. POSITION OF THE THERAPIST- At the side of the patient to be tested. PROCEDURE- Set the pelvis square, level or balance with lower limbs. Measure from ASIS to Medial malleolus. Measure fromIlliac crest to greater trochanter Greater trochanter to knee joint line on lateral aspect Knee joint line on lateral aspect to medial malleolus. FINDING- Record lenght of both legs and compare, the leg measuring less in shortened INTERPRETATION- can be due to Coxa vara and valga Femoral shaft shortening Tibial shaft shortening Respectively according to above 3 measuring methods. APPARENT SHOTENING Same as above but measure from tip of xiphisternum or umblicus to medial malleolus If shortened in lenght then there is functional shortening on the shortened side.