Hip Quadrant Test: Difference between revisions

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Original Editor - [[User:Chapelle Laurent|Chapelle Laurent]]  
Original Editor - [[User:Chapelle Laurent|Chapelle Laurent]]  


Lead Editors &nbsp;  
Lead Editors &nbsp;  


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== Search strategy ==
== Definition/ description ==


I searched for useful medical papers on PubMed, PEDro and Wed of Knowledge. The keywords for the search were Hip Quadrant test, Quadrant Test, Hip tests and diagnosis of the hip. Especially the keywords Quadrant Test and hip tests were very helpful. Although is was difficult to found papers that related to the subject I managed to find a few helpful papers.
The Hip Quadrant test is a passive test that is being applied to asses if there is any damage in structure in the inner and outer quadrant of the hip. The hip quadrant test is also known as the quadrant scour test<ref name="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</ref>. This test is not to be confused to the quadrant test for the lumbar spine.<ref name="6">Lyle MA, Manes S, McGuinness M, Ziaei S, Iversen MD.Relationship of physical examination findings and self-r eported symptom severity and physical function in patients with degenerative lumbar conditions. Phys Ther. 2005 Feb;85(2):120-33.fckLREvidence level: 2a grade of recommendation: B</ref>&nbsp;&nbsp;<br>  
 
<br>I also found very interesting papers and explanations of the technique in several books and magazines thru the option ‘books’ and ‘papers’ on Google. Except for the papers, the books, the figure of the hip and the video of the Quadrant Test the internet didn’t help me to get to additional information.<br>
 
== <br>Defenition/ discription  ==
 
The Hip Quadrant test is a passive test that is being applied to asses if there is any damage in structure in the inner and outer quadrant of the hip. The hip quadrant test is also known as the quadrant scour test [3]. This test is not to be confused to the quadrant test for the lumbar spine. [6] <br>  


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== Clinical relevant anatomy  ==
== Clinically relevant anatomy  ==


The most important structures of the art. coxae are the fossa acetabuli, facies lunata, labrum acetabuli, lig. transversum acetabuli, caput femoris, lig. ischiofemorale, lig iliofemorale and lig. pubofemorale. The art. Coxae is an articulation sphaeroidea.&nbsp;[10]
The most important structures of the art. coxae are the fossa acetabuli, facies lunata, labrum acetabuli, lig. transversum acetabuli, caput femoris, lig. ischiofemorale, lig iliofemorale and lig. pubofemorale. The art. Coxae is an articulation sphaeroidea.<ref name="10">Hunam anatomy atlas Sobotta part 2: lower extremity pg 263 – 272. Bohn Stafleu, Van Loghum
3th print R. Putz and R. Pabst</ref>&nbsp;  


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== Purpose<br>  ==
== Purpose<br>  ==


The purpose of the Hip Quadrant test is to determine if there is a nonspecific hip pathology and a chance of ROM. This test does so by completing the ROM from flexion and adduction to flexion and abduction [1]. This test is also capable to detect early hip degeneration. [5] <br>  
The purpose of the Hip Quadrant test is to determine if there is a nonspecific hip pathology and a chance of ROM. This test does so by completing the ROM from flexion and adduction to flexion and abduction<ref name="1">M. Lynn Palmer – Fundamentels of musculoskeletal assesment techniques pg. 305. Second edition, M lynn palmer and Marcia E. Epler. Uppincott Williams and Willens (publisher)
Evidence level: 5 grade of recommendation: F</ref>. This test is also capable to detect early hip degeneration.<ref name="5">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</ref>&nbsp;<br>  


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== Technique  ==
== Technique  ==


The patient lies with his back on the table (supine position). The therapist stands on the side of the involved leg. He brings the hip and the knee to 90° flexion, the knee is directed towards the opposite shoulder (figure 1). One hand of the therapist is above the patient’s knee, the other is above the malleoli’s. Afterwards the therapist puts pressure on the leg by pushing the femur to dorsal. [7] [1] [3]<br>In the first part of the exam the therapist brings the leg of the patient in adduction. Keep bringing the leg into adduction just before the pelvis begins to raise off the table. <br><br>  
The patient lies supine on the table. The therapist stands on the side of the involved leg. He brings the hip and the knee to 90° flexion, the knee is directed towards the opposite shoulder (figure 1). One hand of the therapist is above the patient’s knee, the other is above the malleolis. Afterwards the therapist puts pressure on the leg by pushing the femur dorsally.<ref name="7">Thomas A. Souza Differential Diagnosis and Management for the Chiropractor: Protocols and algoritms pg 345. Fourth edition, Thomas A. Souza, DC, DACBSP. Jean and Bartlett publishers (Sanburry, Massachussets). 
Evidence level: 5 grade of recommendation: F</ref><ref name="1" /><ref name="3" />&nbsp;
 
<br>In the first part of the exam the therapist adducts the patient's leg until the pelvis begins to raise off the table. <br><br>  


In the second part of the exam the therapist brings the leg of the patient in abduction with the hip still in 90° flexion and goes to abduction until the pelvis almost raises of the table. When he brings the leg to abduction it is important to keep the resistance on the leg and to go to from adduction to abduction in an arch. [3]
In the second part of the exam the therapist brings the leg of the patient in abduction with the hip still in 90° flexion and goes to abduction until the pelvis almost raises of the table. When he brings the leg to abduction it is important to keep the resistance on the leg and to go to from adduction to abduction in an arch.<ref name="3" />&nbsp;


<br>A video of the Quadrant test can be found when clicked on the link under references. [2]<br>  
<br> {{#ev:service|rUO8zeHKOxI}} <br>  


== Result  ==
== Result  ==


The test is considered positive if the patient has any pain. The test is also positive if the therapist can feel any crepitus or if there is a leathery end feeling or if there’s a loss in ROM. [1]<br>The test is considered negative if you can go from flexion-adduction to flexion-abduction in an arch, a normal ROM and with a normal end-feeling. [1] [3]<br><br>  
The test is considered positive if the patient has any pain. The test is also positive if the therapist can feel any crepitus or if there is a leathery end feeling or if there’s a loss in ROM.<ref name="1" />&nbsp;<br>The test is considered negative if you can go from flexion-adduction to flexion-abduction in an arch, a normal ROM and with a normal end-feeling.<ref name="1" /><ref name="3" />&nbsp;<br><br>  


== Disfunction ==
== Dysfunction ==


&nbsp;A positive Hip Quadrant test is an indication that there might be arthritis, an osteochrondral defect, avascular necrosis, joint capsule tightness and an acetabular labrum defect [4]. This test also detects if the patients hip can move in the full range of motion. [7]<br>  
&nbsp;A positive Hip Quadrant test is an indication that there might be arthritis, an osteochrondral defect, avascular necrosis, joint capsule tightness and an acetabular labrum defect<ref name="4">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</ref>. This test also detects if the patients hip can move in the full range of motion.<ref name="7">Thomas A. Souza Differential Diagnosis and Management for the Chiropractor: Protocols and algoritms pg 345. Fourth edition, Thomas A. Souza, DC, DACBSP. Jean and Bartlett publishers (Sanburry, Massachussets). 
Evidence level: 5 grade of recommendation: F</ref><br>  


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== Resources ==
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) ==
<div class="researchbox">
<rss>http://www.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1rE397IRBYUS-ohPvBf0qienQXCg4qPphKx4ex4rwTAQ11NoTW|charset=UTF­8|short|max=10</rss>
</div>
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== References<br>  ==
 
<references />
 
<br>


add aThe resources were Pubmed, PEDro, Web of knowledge and the internet. ny relevant resources here
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== References<br> ==
<br>  


[1] M. Lynn Palmer – Fundamentels of musculoskeletal assesment techniques pg. 305. Second edition, M lynn palmer and Marcia E. Epler. Uppincott Williams and Willens (publisher)<br>Evidence level: 5 grade of recommendation: F
[1] M. Lynn Palmer – Fundamentels of musculoskeletal assesment techniques pg. 305. Second edition, M lynn palmer and Marcia E. Epler. Uppincott Williams and Willens (publisher)<br>Evidence level: 5 grade of recommendation: F  


<br>[2] http://www.youtube.com/watch?v=rUO8zeHKOxI
<br>[2] http://www.youtube.com/watch?v=rUO8zeHKOxI  


<br>[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)<br>Evidence level: 5 grade of recommendation: F
<br>[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)<br>Evidence level: 5 grade of recommendation: F  


<br>[4] 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.<br>Evidence level: 2c grade of recommendation: C  
<br>[4] 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.<br>Evidence level: 2c grade of recommendation: C  
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Evidence level: 3a grade of recommendation: C  
Evidence level: 3a grade of recommendation: C  


 
<br>


[6] &nbsp;Lyle MA, Manes S, McGuinness M, Ziaei S, Iversen MD.Relationship of physical examination findings and self-r eported symptom severity and physical function in patients with degenerative lumbar conditions. Phys Ther. 2005 Feb;85(2):120-33.  
[6] &nbsp;Lyle MA, Manes S, McGuinness M, Ziaei S, Iversen MD.Relationship of physical examination findings and self-r eported symptom severity and physical function in patients with degenerative lumbar conditions. Phys Ther. 2005 Feb;85(2):120-33.  
Line 76: Line 80:
Evidence level: 2a grade of recommendation: B  
Evidence level: 2a grade of recommendation: B  


 
<br>


[7] Thomas A. Souza Differential Diagnosis and Management for the Chiropractor: Protocols and algoritms pg 345. Fourth edition, Thomas A. Souza, DC, DACBSP. Jean and Bartlett publishers (Sanburry, Massachussets). <br>Evidence level: 5 grade of recommendation: F  
[7] Thomas A. Souza Differential Diagnosis and Management for the Chiropractor: Protocols and algoritms pg 345. Fourth edition, Thomas A. Souza, DC, DACBSP. Jean and Bartlett publishers (Sanburry, Massachussets). <br>Evidence level: 5 grade of recommendation: F  


<br>


Figure 1: [8] http://www.healthbase.com/resources/images/Birmingham_Hip_Resurfacing/anatomy_human_hip.jpg last checked on 23/12/11


Figure 1: [8] http://www.healthbase.com/resources/images/Birmingham_Hip_Resurfacing/anatomy_human_hip.jpg last checked on 23/12/11
Figure 2: [9] http://www.jbjs.org/article.aspx?Volume=83&amp;page=438 last checked on 22/11/12  


Figure 2: [9] http://www.jbjs.org/article.aspx?Volume=83&amp;page=438 last checked on 22/11/12
<br>[10] Hunam anatomy atlas Sobotta part 2: lower extremity pg 263 – 272. Bohn Stafleu, Van Loghum<br> 3th print R. Putz and R. Pabst<br><br>


<br>[10] Hunam anatomy atlas Sobotta part 2: lower extremity pg 263 – 272. Bohn Stafleu, Van Loghum<br> 3th print R. Putz and R. Pabst<br><br>
[[Category:Special_Tests]][[Category:Musculoskeletal/Orthopaedics|Orthopaedics]][[Category:Hip]]

Revision as of 22:37, 30 June 2014


Original Editor - Chapelle Laurent

Lead Editors  

Definition/ description[edit | edit source]

The Hip Quadrant test is a passive test that is being applied to asses if there is any damage in structure in the inner and outer quadrant of the hip. The hip quadrant test is also known as the quadrant scour testCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. This test is not to be confused to the quadrant test for the lumbar spine.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title  


Clinically relevant anatomy[edit | edit source]

The most important structures of the art. coxae are the fossa acetabuli, facies lunata, labrum acetabuli, lig. transversum acetabuli, caput femoris, lig. ischiofemorale, lig iliofemorale and lig. pubofemorale. The art. Coxae is an articulation sphaeroidea.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title 


Purpose
[edit | edit source]

The purpose of the Hip Quadrant test is to determine if there is a nonspecific hip pathology and a chance of ROM. This test does so by completing the ROM from flexion and adduction to flexion and abductionCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. This test is also capable to detect early hip degeneration.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title 


Technique[edit | edit source]

The patient lies supine on the table. The therapist stands on the side of the involved leg. He brings the hip and the knee to 90° flexion, the knee is directed towards the opposite shoulder (figure 1). One hand of the therapist is above the patient’s knee, the other is above the malleolis. Afterwards the therapist puts pressure on the leg by pushing the femur dorsally.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title 


In the first part of the exam the therapist adducts the patient's leg until the pelvis begins to raise off the table.

In the second part of the exam the therapist brings the leg of the patient in abduction with the hip still in 90° flexion and goes to abduction until the pelvis almost raises of the table. When he brings the leg to abduction it is important to keep the resistance on the leg and to go to from adduction to abduction in an arch.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title 


EmbedVideo does not recognize the video service "service".


Result[edit | edit source]

The test is considered positive if the patient has any pain. The test is also positive if the therapist can feel any crepitus or if there is a leathery end feeling or if there’s a loss in ROM.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title 
The test is considered negative if you can go from flexion-adduction to flexion-abduction in an arch, a normal ROM and with a normal end-feeling.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive titleCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title 

Dysfunction[edit | edit source]

 A positive Hip Quadrant test is an indication that there might be arthritis, an osteochrondral defect, avascular necrosis, joint capsule tightness and an acetabular labrum defectCite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title. This test also detects if the patients hip can move in the full range of motion.Cite error: Invalid <ref> tag; name cannot be a simple integer. Use a descriptive title


Recent Related Research (from Pubmed)[edit | edit source]


Failed to load RSS feed from http://www.ncbi.nlm.nih.gov/entrez/eutils/erss.cgi?rss_guid=1rE397IRBYUS-ohPvBf0qienQXCg4qPphKx4ex4rwTAQ11NoTW|charset=UTF­8|short|max=10: Error parsing XML for RSS



 

References
[edit | edit source]





[1] M. Lynn Palmer – Fundamentels of musculoskeletal assesment techniques pg. 305. Second edition, M lynn palmer and Marcia E. Epler. Uppincott Williams and Willens (publisher)
Evidence level: 5 grade of recommendation: F


[2] http://www.youtube.com/watch?v=rUO8zeHKOxI


[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


[4] 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

[5] 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.

Evidence level: 3a grade of recommendation: C


[6]  Lyle MA, Manes S, McGuinness M, Ziaei S, Iversen MD.Relationship of physical examination findings and self-r eported 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


[7] Thomas A. Souza Differential Diagnosis and Management for the Chiropractor: Protocols and algoritms pg 345. Fourth edition, Thomas A. Souza, DC, DACBSP. Jean and Bartlett publishers (Sanburry, Massachussets).
Evidence level: 5 grade of recommendation: F


Figure 1: [8] http://www.healthbase.com/resources/images/Birmingham_Hip_Resurfacing/anatomy_human_hip.jpg last checked on 23/12/11

Figure 2: [9] http://www.jbjs.org/article.aspx?Volume=83&page=438 last checked on 22/11/12


[10] Hunam anatomy atlas Sobotta part 2: lower extremity pg 263 – 272. Bohn Stafleu, Van Loghum
3th print R. Putz and R. Pabst

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