In medicine, physiotherapy, chiropractic, and osteopathy the hip examination, or hip exam, is undertaken when a patient has a complaint of hip pain and/or signs and/or symptoms suggestive of hip joint pathology. It is a physical examination maneuver. Examination steps The hip examination, like all examinations of the joints, is typically divided into the following sections: Position/lighting/draping Inspection Palpation Motion Special maneuvers The middle three steps are often remembered with the saying look, feel, move. Position/lighting/draping Position – for most of the exam the patient should be supine and the bed or examination table should be flat. The patient's hands should remain at their sides with the head resting on a pillow. The knees and hips should be in the anatomical position (knee extended, hip neither flexed nor extended). Lighting – adjusted so that it is ideal. Draping – both of the patient's hips should be exposed so that the quadriceps muscles and greater trochanter can be assessed. Inspection Inspection done while the patient is standing Look Front and back of pelvis/hips and legs and comment on Ischaemic or trophic changes· Level of ASIS (anterior superior iliac spine) Swelling (soft tissue, bony swellings) Scars (old injuries, previous surgery) Sinuses (infection, neuropathic ulcers) Wasting (old polio, Carcot-Marie-Tooth) or hypertrophy (e.g. calf pseudohypertrophy in muscular dystrophy) Deformity (leg length discrepancy, pes cavus, scoliosis, lordosis, khyphosis) Feel Any swellings·Anteriorly in scarpas triangle, Trochanteric region or gluteal region Pelvic tilt by palpating level of ASIS (anterior superior illiac spine) Move· Gait: Observe Smooth and progression of phases of gait cycle Comment on stance, toe-off, swing heel strike, stride and step length Sufficient flexion/extension at hip/knee ankle and foot: Any fixed contractures? Arm-swing and balance on turning around· Abnormal Gait Patterns Trendelenburg (pelvic sway/tilt, aka waddling gait if bilateral) Broad-based (ataxia) High-stepping (loss of proprioception/drop foot) Antalgic (mention “with reduced stance phase on left/right side”) In-toeing (persistent femoral anteversion) Inspection done while supine The hip should be examined for: Masses Scars Lesions Signs of trauma/previous surgery Bony alignment (rotation, leg length) Muscle bulk and symmetry at the hip and knee Measures True leg length – Greater Trochanter of the femur or Anterior Superior Iliac Spine of pelvis to medial malleolus of ipsilateral leg. Apparent leg length – umbilicus or xiphisternum (noting which is used) to the medial malleolus of ipsilateral leg. In hip fractures the affected leg is often shortened and externally rotated. Palpation The