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Involuntary extension of the "normal" leg occurs when flexing the contralateral leg against resistance. To perform the test, the examiner should hold one hand under the heel of the "normal" limb and ask the patient to flex the contralateral hip against resistance (while the patient is supine), asking the patient to keep the weak leg straight while raising it.
In some cases, an audible snapping or popping noise as the tendon at the hip flexor crease moves from flexion (knee toward waist) to extension (knee down and hip joint straightened). It can be painless. [2] After extended exercise, pain or discomfort may be present caused by inflammation of the iliopsoas bursae. [3]
The straight leg raise is a test that can be performed during a physical examination, with the leg being lifted actively by the patient or passively by the clinician. If the straight leg raise is done actively by the patient, it is a test of functional leg strength, particularly the rectus femoris element of the quadriceps (checking both hip flexion and knee extension strength simultaneously).
The psoas sign, also known as Cope's sign (or Cope's psoas test [1]) or Obraztsova's sign, [2] is a medical sign that indicates irritation to the iliopsoas group of hip flexors in the abdomen, and consequently indicates that the inflamed appendix is retrocaecal in orientation (as the iliopsoas muscle is retroperitoneal).
Sometimes, with a very flexible patient, the Thomas test will be normal despite a psoas dysfunction being present. However, in the patient with a normal hip joint, a positive test is a good indicator of psoas hypertonicity. [2] Other signs from the Thomas test: opposite/ contralateral hip flexes without knee extension- tight iliopsoas
The obturator sign, also called Cope's obturator test, is an indicator of irritation to the obturator internus muscle. [1] The technique for detecting the obturator sign, called the obturator test, is carried out on each leg in succession. The patient lies on her/his back with the hip and knee both flexed at ninety degrees.
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Stabilize the pelvis and let the affected leg drop. A positive test is indicated if the leg does not adduct to the table. [1] Thomas test for tight hip flexors both performed by the provider holding the unaffected leg to the chest and leaving the affected leg on the table. If the affected leg cannot lie flat on the table it is a positive test. [1]