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Hip OSCE Examination Quiz

Focused SBA-style practice, followed by the answer and explanation for every question.

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You have completed the main parts of a focused hip examination and found reduced internal rotation with groin pain. How should you finish the examination?

Close professionally, summarise the findings, and postpone walking-aid assessment until cross-sectional imaging has been completed. Close professionally, summarise the findings, and request inflammatory blood tests and plain radiographs of the pelvis to look for the cause of the groin pain. Close professionally, summarise the findings, and request an MRI of the hip and lumbar spine before examining the knee or assessing gait. Close professionally, summarise the findings, and assess the spine, knee, lower limb neurovascular status, gait and imaging needs. Close professionally, summarise the findings, and examine the opposite hip to compare its range of movement.

A Close professionally, summarise the findings, and postpone walking-aid assessment until cross-sectional imaging has been completed.
B Close professionally, summarise the findings, and request inflammatory blood tests and plain radiographs of the pelvis to look for the cause of the groin pain.
C Close professionally, summarise the findings, and request an MRI of the hip and lumbar spine before examining the knee or assessing gait.
D Close professionally, summarise the findings, and assess the spine, knee, lower limb neurovascular status, gait and imaging needs. ✓
E Close professionally, summarise the findings, and examine the opposite hip to compare its range of movement.

The answer is D: Close professionally, summarise the findings, and assess the spine, knee, lower limb neurovascular status, gait and imaging needs.

Explanation

Why D is correct

See Completing the Examination. Option D is correct. A good close to a hip examination is more than finishing the local movements. You thank the patient, make sure they are comfortable and able to dress, wash your hands, and summarise the findings, here reduced internal rotation with groin pain. You then say which further assessments you would offer. You would examine the lumbar spine and the knee, because problems in these can refer pain to the hip, and hip disease can be felt in the knee: for instance, groin tenderness and pain on internal rotation of the hip can explain knee pain. You would also do a lower limb neurovascular assessment (checking nerves and circulation), a functional assessment that includes how the patient walks and whether they use a stick or frame, and request imaging, such as plain X-rays of the pelvis and the affected hip, when it is indicated.

Close: thank the patient, let them dress, wash your hands and summarise the findings
Joints: examine the lumbar spine and the knee, as problems there can refer pain to the hip
Function: assess lower limb neurovascular status, gait and use of walking aids
Imaging: plain X-rays of the pelvis and affected hip when indicated

Why the other options are incorrect

A. Close professionally, summarise the findings, and postpone walking-aid assessment until cross-sectional imaging has been completed.: Gait and walking aids are part of the functional assessment and should not be put off just because imaging may follow. Gait and walking aids belong to the functional assessment.
B. Close professionally, summarise the findings, and request inflammatory blood tests and plain radiographs of the pelvis to look for the cause of the groin pain.: Blood tests and plain radiographs may be indicated, but they do not replace the clinical assessment of the lumbar spine, knee, lower limb neurovascular status and gait, and referred pain must still be considered.
C. Close professionally, summarise the findings, and request an MRI of the hip and lumbar spine before examining the knee or assessing gait.: An MRI is not the next step before completing the clinical examination; the knee, lumbar spine, neurovascular status and gait must be assessed first, and imaging is requested only when it is indicated.
E. Close professionally, summarise the findings, and examine the opposite hip to compare its range of movement.: Comparing the opposite hip is useful, but it leaves out the lumbar spine, the knee, the lower limb neurovascular status and functional assessment, so it is not enough to finish the examination.

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More questions from this set. Start the quiz to answer them and see each explanation.

1
A 64-year-old man has chronic right hip stiffness, with no hip replacement or recent injury. With consent, you perform Thomas's test: he lies supine while you flex his left hip until the lumbar curve flattens onto your supporting hand. His right thigh then rises from the couch. What does this finding indicate?
2
You are assessing passive right hip movement in a consenting patient with chronic groin pain. The patient lies supine, with the right hip and knee both flexed to 90 degrees. Keeping the thigh in position, you move the right foot outwards, away from the midline. Which hip movement are you testing?

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