Inspection

Examination of the hip should begin with inspection. Look at the patient's gait when entering the room. The patient may use some form of support while walking e.g. stick or frame. Assess the patient for a limp. If it is present, the examiner needs to determine what type of limp it is e.g. antalgic, short-leg, Trendelenburg lurch.

Assess stability by the Trendelenburg Test.

Ask the patient to disrobe as both the hip and associated areas need to be examined. Examine the patient standing and then supine. Look for:

• swelling and erythema - rare because of the deep position of the joint
• scars
• sinuses
• abrasion
• discolouration
• lumbar lordosis
• muscle wasting
• position of the limb
• gluteal folds: increases on hip flexion, decreases on extension
• apparent leg length shortening

Pelvic obliquity may be indicated on standing by:

• the two anterior superior iliac spines not being horizontal
• posteriorly, the dimples superior to the buttocks - indicating the posterior superior iliac spines - not being horizontal