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Klein's line or the line of Klein is a virtual line that can be drawn on an X-ray of an adolescent's hip parallel to the anatomically upper edge of the femoral neck.It was the first tool to aid in the early diagnosis of a slipped capital femoral epiphysis (SCFE), which if treated late or left untreated leads to crippling arthritis, leg length discrepancy and lost range of motion.
5.1 Normal range of motion. 6 Special maneuvers. 7 Other tests. 8 See also. 9 References. ... In medicine, physiotherapy, chiropractic, and osteopathy the hip ...
The Harris Hip Score (HHS) is a common evaluation instrument of the results of various hip disabilities and methods of treatment, especially for the assessment of hip replacement. [1] It was developed by William H. Harris in 1969 with 30 patients who had suffered a fracture of the acetabulum or a luxation of the hip. [2]
Normal values range between 5 and 25°. Retroversion is considered abnormal. [1] Femoral torsion is the angle between a line along the femoral head and neck axis and a second line that is touching the posterior border of both femoral condyles. The normal value at birth is approximately 32° and decreases gradually with age.
Physical exam should also involve assessing passive internal rotation of the hip during flexion, as range of motion is reduced in proportion to the size of a cam lesion. [10] Flexing the hip to 90 degrees, adducting, and internally rotating the hip, known as the FADDIR test, should also be performed. [10] It is positive when it causes pain.
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 diagnosis is a combination of clinical suspicion plus radiological investigation. Children with a SCFE experience a decrease in their range of motion, and are often unable to complete hip flexion or fully rotate the hip inward. [10] 20–50% of SCFE are missed or misdiagnosed on their first presentation to a medical facility.
Normal values range between 5 and 12 mm. Differences greater than 1.5 mm between the two sides are considered abnormal. Reimer's migration index. Reimer's migration index (MI), also called the femoral extrusion index, [3] is calculated if hip dysplasia is detected.