Hip in afya

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''Physical''
Check L spine
Trendelenburg - stand on one leg - pelvis should remain level, 
ROM - FABIR FADER
De-rotation stress test - lie on back, flex hip and knee, NO Ab or Ad uction then rotate int or ext and pt return to neutral
Palpation - ASIS, GT, Pubic tubercle

''Hip OA''
buttock pain, instability, struggle to put shoes and socks on, Sx inc with walking - dec ROM, trendelenburg pos

''Lateral hip pain (greater trochanteric pain syndrome)''
post-men obese women, pain going up stairs / hills, unable to lie on that side, sore to palpate greater tronchanter - de-rotation stress test pos, inc strength of gluteus

''Hip dysplasia''
lateral hip pain, clunking/clicking, progressive, ?limp FADIR (hip irritation classic) and FABER (hip and SIJ)

''Hip impingement'' (femero-acetabulum) 
recurrent groin strain, clicking/clunking, instable/locking, Csign, FADIR and FABER

''Also think ..''
L Spine
Avasular necrosis / transient osteoporosis
Chronic sporting injury
Non MSK - mets

25% at 3/12, 35% at 12/12 sustained improvement
OA - conservative Mx - Sx progress in 15% at 3yr, 28% at 6yrs - fluctuating pain
Bursitis - 64% improve at 1yr, 71% at 5yr - without injection (?)

Consider Xray AP pelvis

Trendelenburg ...
if weak on right will sink to left when left foot off ground, so on walking - lurchs to affected side to pick left leg up fully

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