Definition/Description
The Hip Quadrant test is a non-functional test used to determine if the hip is contributing to a patient’s symptoms. The hip quadrant test is also known as the quadrant scour test[1][2]. This test should not be confused with the quadrant test for the lumbar spine.[3]
Clinically Relevant Anatomy
The hip articulation is a true diarthroidal ball and-socket style joint that forms from the head of the femur as it articulates with the acetabulum of the pelvis. These joints form the main link between the base and the trunk and usually operate in a closed kinematic chain[4]. That’s the way it is it’s designed to be stable and weight-bearing – rather than highly mobile. The movements of the hip joint are flexion extension abduction adduction internal rotation and external rotation. The hip joint muscles work to increase stability. They can be divided into two groups akuw – intracapsular ne extracapsular.
For detailed information on the anatomy of the posterior lumbar spine and the Sacroiliac Joint.
The most important structures of the art. thigh is the lunar face of the lip of the fossa acetabulum lig of the acetabulum. ligature transverse acetabulum head of femur. ischiofemoral ligament iliofemoral ligament. pubofemoral of the posterior Art. The hip is a rounded joint.[5] [6] .
Purpose
The purpose of the hip quadrant test is to determine the presence of nonspecific hip pathology and changes in ROM. This test is accomplished by completing a ROM from flexion and adduction to flexion and abduction [7] [2]. The test is also able to detect early hip degeneration. [8]
Technique
The patient lies supine on the base. The therapist stands on the side of the leg being tested. Place the affected limb in adduction and apply and maintain compressive force through the femur through a range of hip flexion of 70-140 degrees. Test repeated on kidnapping. A positive test is a recurrence of the worst pain the patient had when they entered the clinic. [9][10][7][1][1]
Interpretation
The test is considered positive if the patient has any pain. The test is also positive if the therapist can feel any crepitus or have a gritty end sensation or loss of ROM. [7][2]
The test is considered negative if you can go from flexion adduction to flexion abduction in a normal ROM and normal end sensation. [7][1]
This test performs pathological examination by examining the femoroacetabular joint. The compression of the femur in different ranges causes pressure on the labrum cartilage ligament and so on. Although this test has been labeled as a hip clearance test due to its low diagnostic accuracy, it does not have to be Use like this. Consider the results of the remaining examinations when attempting to determine pathology. [9]
Dysfunction
A positive hip quadrant test indicates the possible presence of arthritis, osteochondral defect, avascular necrosis, joint capsule tightness, and/or acetabular lip defect [11]. The test also detects whether the patient’s hip can move through its full range of motion. [10]
Evidence
The hip quadrant test doesn’t give us any very useful information. Due to the wide range of structures that can be emphasized, their results should be interpreted with caution. No validity or reliability studies of its diagnostic effectiveness could be found.
There is little data available on the importance of the hip quadrant. However, the American College of Rheumatology offers another way to diagnose hip OA.
There are 2 cluster diagnoses which are:
Cluster 1:
- Pain in the hip
- <115 degrees of hip flexion
- < 15 degrees of hip IR
Cluster 2:
- Pain with hip IR
- > 60 minutes of AM stiffness
- > 50 years old[12]
If at least 4 of the 5 variables were present, the positive LR was equal to 24.3 (95% confidence interval: 4.4-142.1), increasing the probability of hip OA to 91%. [12]
References
- ↑ Jump up to:1.0 1.1 1.2 1.3 ] Peter H. Seidenberg,Jimmy D. Bowen – The Hip and Pelvis in Sports Medicine and Primary Care pg. 33. Peter H. Seidenberg and Jimmy D. Bowen (editors). Springer (publisher) Evidence level: 5 grade of recommendation: F
- ↑ Jump up to:2.0 2.1 2.2 Cook CE, Hegedus EJ. Orthopedic Physical Examination: An Evidence based Approach. Upper Saddle River, NJ: Pearson Prentice Hall; 2008.
- ↑ Lyle MA, Manes S, McGuinness M, Ziaei S, Iversen MD.Relationship of physical examination findings and self-reported symptom severity and physical function in patients with degenerative lumbar conditions. Phys Ther. 2005 Feb;85(2):120-33. Evidence level: 2a grade of recommendation: B
- ↑ Hip Anatomy. (2017, June 6). Physiopedia, . Retrieved 10:17, December 14, 2017 from https://www.physio-pedia.com/index.php?title=Hip_Anatomy&oldid=172875.
- ↑ Human anatomy atlas Sobotta part 2: lower extremity pg 263 – 272. Bohn Stafleu, Van Loghum 3th print R. Putz and R. Pabst
- ↑ figure 1: http://www.healthbase.com/resources/images/
- ↑ Jump up to:7.0 7.1 7.2 7.3 M. Lynn Palmer – Fundamentals of musculoskeletal assessment techniques pg. 305. Second edition, M lynn palmer and Marcia E. Epler. Uppincott Williams and Willens (publisher) Evidence level: 5 grade of recommendation: F
- ↑ Manning C, Hudson Z. Comparison of hip joint range of motion in professional youth and senior team footballers with age-matched controls: an indication of early degenerative change? Phys Ther Sport. 2009 Feb;10(1):25-9. Epub 2008 Dec 24.fckLREvidence level: 3a grade of recommendation: C
- ↑ Jump up to:9.0 9.1 https://www.thestudentphysicaltherapist.com/hip-quadrant-test.html
- ↑ Jump up to:10.0 10.1 Thomas A. Souza Differential Diagnosis and Management for the Chiropractor: Protocols and algorithms pg 345. Fourth edition, Thomas A. Souza, DC, DACBSP. Jean and Bartlett publishers (Sanburry, Massachusetts). Evidence level: 5 grade of recommendation: F
- ↑ Mitchell B, McCrory P, Brukner P, O’Donnell J, Colson E, Howells R. Hip joint pathology: clinical presentation and correlation between magnetic resonance arthrography, ultrasound, and arthroscopic findings in 25 consecutive cases. Clin J Sport Med. 2003 May;13(3):152-6. Evidence level: 2c grade of recommendation: C
- ↑ Jump up to:12.0 12.1 Altman R, Alarcon G, Appelrouth D, et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum 1991: 34l 505-514.