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DOC Left Hip Exam
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Inspection (swelling, erythema, ecchymosis, warmth, masses, wounds, deformities)
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Inspection Abnormal?
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Inspection ALL NORMAL?
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Swelling?
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Ecchymosis?
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Erythema?
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Increased Warmth?
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Open Wounds?
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Deformity?
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Masses?
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Inspection Comments
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Tenderness (ASIS, PSIS, trochanter, groin, buttocks)
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Tenderness Abnormal?
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Tenderness ALL NORMAL?
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ASIS?
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PSIS?
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Greater Trochanter?
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Groin?
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Buttocks?
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Tenderness Comments
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ROM (flexion, int/ext rotation, abduction)
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ROM Abnormal?
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ROM ALL NORMAL?
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Limited Flexion?
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Limited Internal Rotation?
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Limited External Rotation?
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Limited Abduction?
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AROM Comments
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Strength (flexion, abduction, adduction)
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Strength Abnormal?
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Strength ALL NORMAL?
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Hip Flexion Strength Decreased?
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Hip Abduction Strength Decreased?
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Hip Adduction Strength Decreased?
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Sensation
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Sensation Intact Throughout Lower Extremity?
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Sensation Comments
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Vascular (dorsalis pedis/post tibialis pulse)
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Vascular Abnormal?
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Vascular ALL NORMAL?
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Dorsalis Pedis Pulse Palpable?
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Posterior Tibialis Pulse Palpable?
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Vascular Comments
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Tests
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FABER Test Positive?
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Comments
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Trendelenburg Test Positive?
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Comments
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Ober's Test Positive?
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Comments
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Thomas Test Positive?
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Comments
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Axial Load Test Positive?
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Comments
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Gait (ambulation w/limp or unable, asst device used?)
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Gait Abnormal?
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Gait ALL NORMAL?
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Ambulates with Limp?
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Unable to Ambulate?
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Assistive Devices Used for Mobility?
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Assistive devices
• • •
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Assistive devices
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Gait Comments
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Imaging and Labs
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Hip X-Ray?
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X-Ray Views
• • •
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Comparison
• • •
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Comparison Date and Comments
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Normal Findings
• • •
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Normal Comments
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Abnormal Findings
• • •
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Abnormal Comments
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Impression:
• • •
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Comments:
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Pelvis X-Ray?
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X-Ray Views
• • •
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Comparison
• • •
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Comparison Date and Comments
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Normal Findings
• • •
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Normal Comments
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Abnormal Findings
• • •
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Abnormal Comments
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Impression:
• • •
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Comments:
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Ultrasound Utilized?
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Normal US Findings
• • •
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Normal US Comments
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Abnormal US Findings
• • •
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Abnormal US Comments
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Abnormal US Findings
• • •
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Ultrasound Comments:
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