Why Examine a Hip?

The study by Chadayammuri et al. is one where, at first glance, the title and probable findings do not garner much interest for the average reader. However, with the increasing awareness of intra-articular hip disorders prior to the onset of substantial degenerative changes that has been noted in the recent literature because of the advent of hip arthroscopy, it is clear that this study is important. There is a growing need to establish a range of values for physical examination measurements in groups of symptomatic and asymptomatic individuals. The hip is one of the areas where these algorithms have not been developed to the same extent as for other joints. Classically, many of us were trained to simply examine the adult hip for range of motion limitations, review the radiographs, and tell patients either that they needed a total hip replacement or that they should wait until they needed one to resolve their hip pain! That is no longer acceptable.

If range of motion and provocative testing can be used as screening tests, preventative strategies may be developed and implemented. Furthermore, the need for imaging studies may be markedly reduced. This is becoming an increasingly more important aspect of treating our patients not only in the most clinically efficacious manner, but also taking cost into consideration.

The clinical algorithms that establish the need for, or exclude the necessity of, advanced imaging studies are clearly lacking in any scientifically valid fashion. This study helps to establish a baseline that can be used for further refinement and clarification of hip pathoanatomy.