Rotation can be measured in flexion or extension.
Rotation in flexion is measured with the hip and knee flexed to 90 degrees. Lateral movement of the foot pivoting at the knee should produce internal rotation of the hip. Medial movement of the foot produces external rotation at the hip. The normal range of both movements is about 45 degrees.
Rotation in extension involves shifting the patient from the supine to prone positions. The knees are flexed and the feet moved laterally or medially to produce again respectively, internal and external rotation at the hip. The normal ranges are 35 and 45 degrees respectively.
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