Palpation

Palpation of the hip should be carried out in the position that is most comfortable for the patient. However, ideally at some point the patient must stand to reveal pathology only evident on weight-bearing.

As with any palpation, first contact must be gentle but firm to reassure the patient.

Particular attention must be paid to:

• skin temperature
• areas of tenderness
• crepitations in the head of the femur - by feeling below the inguinal ligament while rotating internally and externally
• joint tenderness - by pressing the greater trochanter and by deep palpation in the groin
• tenderness over the ischial tuberosity - indicative of tears to the hamstrings
• tenderness over the lesser trochanter - indicative of tears of the ilio-psoas

Note that hip joint is often too deep to assess effusion or synovial thickening. Palpation has an important role in assessing apparent limb shortening - see submenu.

Within the submenu, palpation has been divided arbitrarily into:

• bony palpation
• soft tissue palpation