Hip Quadrant Test

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Search strategy

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.
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 and the books the internet didn’t help me to get to additional information.

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.

Clinical 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.

Purpose

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

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. 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. 
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.
assessment technique here

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
A video of the Quadrant test can be found when clicked on the link under references.

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.
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.

Disfunction

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. This test also detects if the patients hip can move in the full range of motion.

Resources

add aThe resources were Pubmed, PEDro, Web of knowledge and the internet. ny relevant resources here

References

M. Lynn Palmer – Fundamentels of musculoskeletal assesment techniques pg. 305
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
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.

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.

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.

7 Thomas A. Souza Differential Diagnosis and Management for the Chiropractor: Protocols and algoritms pg 345