By Dos Winkel

Medical Society of Flemish basic Practitioners, Antwerp, Belgium. Translation, edition, and compilation of 3 titles formerly released in Dutch. Halftone illustrations. 7 members, three U.S. DNLN: Leg.

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Example text

The patient standing and walking, the patient's history, and the functional examina­ tion have to be performed carefully and thor­ oughly. General Inspection As the patient enters the room, the exam­ iner should observe the gait pattern, general posture, facial expression, and whether the patient uses assistive devices. Many distur­ bances in gait are characteristic of specific disorders. History (Refer also to "History" in Diagnosis and Treatment oj the Sp'ine, pp. ) Age, Occupation, Hobby, Sport Many disorders of the hip are only seen at specific ages.

The patient is now instructed to straighten the knee without lifting the thigh. At the same time, the examiner provides isometric resis­ tance with the extended arm. Examination oj the Hip This tests the quadriceps muscles for strength and painfulness. The rectus femoris muscle plays the most important role in hip pathology. 25 Resisted Knee Flexion, with the Knee in 70° Flexion The examiner stands next to the side being tested, at the level of the patient's upper body. The patient flexes the knee to 70°.

The disorder is sel­ dom seen in people younger than 20 years. The trauma usually involves hyperextension, rotation, or combinations of these conditions. A patient with coxarthrosis can develop trau­ matic arthritis of the hip as the result of over­ use or from an accident. Such cases are cat­ egorized as being an activated or traumatized arthrosis. Nontraumatic Arthritis The most frequently seen nontraumatic arthritides of the hip are rheumatoid arthritis, gout, ankylosing spondylitis, and arthritis re­ sulting from pigmented villonodular synovitis (Figure 4-1).

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