Hip Examination - Orthopaedic Hip OSCE - Medicine Explained - Clinical Skills - Dr Gill
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- Опубликовано: 15 июн 2024
- Hip Examination - Orthopaedic Hip OSCE - Medicine Explained - Clinical Skills - Dr Gill
This Hip Exam Deep Dive looks at the details of the examination of a patient with Hip issues, highlighting what is being checked for during special tests and examination findings
In this video, we demonstrate how to perform a clinical examination of the hip for your medical school Clinical Skills OSCE. As orthopaedic exams are core skills when it comes to examining patients, students should assume that a hip assessment is a high yield station for any clinical exams or clinical assessments.
For a passing grade in your Clinical Skills OSCE, in a hip exam follow the approach of:
- Look
- Feel
- Move
HOWEVER, a hip examination OSCE station does not just involve pressing around the joint, as this video also demonstrates some of the specialised examination techniques required in examining patients such as the Thomas test for fixed flexion deformity, FADIR, and FABER tests
Reduction in movement, pain and general concerns about hip issues is a common reason for patients to see a doctor, and in general practice is probably one of the hardest joints to accurately diagnose a problem in due to the depth within the body
This video has TWO other hip demonstration videos associated with it:
• Hip Joint Clinical Exa... - Hip assessment Demo
• GALS Screen - Gait, Ar... - Gait, Arms, Legs, Spine - GALS screen
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Please note that there is no ABSOLUTE way to perform a clinical examination. Different institutions and even clinicians will have differing degrees of variations - the aim is the effectively identify medically relevant signs.
However during OSCE assessments. Different medical schools, nursing colleges and other health professional courses will have their own preferred approach to a clinical assessment - you should concentrate on THEIR marks schemes for your assessments.
The examination demonstrated here is derived from Macleods Clinical Examination - a recognised standard textbook for clinical skills.
Some people viewing this medical examination video may experience an ASMR effect
#clinicalskills #Hip #DrGill
You can now consult via video or in person with Dr Gill at Dr Finlay’s Private Practice - www.drfinlays.co.uk/services/...
00:00 - Introduction
00:37 - Patient Introduction and Examination Overview
01:14 - LOOK: Assessing Deformities and Symmetry
03:24 - Abnormal Gait Patterns
04:17 - Trendelenburg's Test for Hip Weakness
05:19 - FEEL: Identifying Hip and Pelvis Discomfort
06:50 - Measuring Leg Length Discrepancy
08:46 - Identifying Apparent Leg Length Discrepancy
09:50 - Thomas' Test for Fixed Flexion Deformity
11:33 - MOVE: Assessing Hip's Range of Movement
13:27 - Testing Internal and External Rotation
14:40 - Extension Testing Methods
15:50 - F.AB.ER and F.AD.IR Tests for Joint Discomfort
16:45 - Conclusion and Final Thoughts
I love that you’ve been adding “abnormal” indications, and not just running thru the exam with only the findings from a completely healthy subject.
Well, trying to simulate them anyway
In my “grand plan” for the channel, each examination would be covered three times
1- Demo (most are covered, only a few niche ones left
2- Deep dives - explaining what is going on, and ensuring my headaches remain constant 😊
3 - patient examinations demonstrating pathology - but that will be a difficult one to cover
I've often thought this- many such videos run through the findings for a fully able and healthy 22 year old.
But at medical school we HAVE to train in normal - it actually annoys the students a little - but we want to normal examination burned into their minds, so when they finally find something abnormal it sticks out like a sore thumb
A big part of the education at medical school isn’t being able to immediately say “this is the problem” we’ve loads of resources to help with that. The challenge to being able to pick up an abnormality on someone, especially if that wasn’t expected.
We can investigate something if we find it. But if we’re only focusing on what we’ve seen /been taught at “not normal” we can miss things 😊
(It bugged me at med school, but now it makes a lot of sense)
Vgyuu9987iiìyy77u88788888878togettoseeiftheproblem
Just found out I got into medical school (Class of 2026!) and in a strange way, your videos helped keep me distracted during the very long, tedious process. Thanks for all you do, Dr. Gill!!
Magnificent!!! That is great news!! Where will you be studying?
@@DrJamesGill at South Hampton Institute of Technology S.H.I.T.
@@DrJamesGill I'm Canadian, so I'm studying here! We're in the middle of a bit of a doctor shortage so I plan on staying put :)
@@jasonbutler5226 🤣🤣🤣🤣
@@jasonbutler5226 South Harmon**
11:26 I'm glad you kept that part in
I didn’t think I had - slipped up on the edit
@@DrJamesGill certainly leave these little moments in, they add a touch of character without detracting from what you're teaching
Megan's laugh is so adorable!!
11:19 - This was unexpected but well composed James
I’ve always wondered if you’d ever show any tests with abnormal signs in them not just a perfectly fine exam. Really cool Doc !
It is easier to demonstrate on SOME msk exams
I learned a few years ago that one of my legs is shorter than the other. I went so long without knowing that it's essentially permanent. Been wearing a heel lift since and it has made a big difference. Very informative, as always.
Glad I discovered your channel. Real and educational forms of ASMR are my favourite.
Though I’m just here for the ASMR I appreciate that you show what ist looks like when thinks are wrong. That would help me immensely if I was a medical student.
👍 there has been great feedback on here and I’m trying to adapt to create better videos 😊
Both the doctor and the patient are attractive as hell and the video is just as equally informative. 10/10 would watch again
Keep up the good work Dr. appreciate the insight these provide to us non medical professionals.
👍👍
Hi Dr. Gill, just a suggestion: Perhaps you could include a bloopers section at the end of each video. Nice video.
Great video. I love demonstrations of what the red flags would look like in addition to the regular exam. The use of diagrams and other visuals are much appreciated as well!
Red flags are difficult to demonstrate, and honestly I think better to discuss, so that the range of variation and WHY can be covered
Great video Dr. Gil, love finding baseline and then showing abnormal findings. We see a lot of falls or lumbar pain that go to our ER, great assessment tool (the video). Thank you from Texas 😎👍
Another great informative video as always! I really appreciate these even though I’m not the originally intended audience because they help me understand my own body better and how to pay attention to it if something feels off to seek help before too many problems arise as a result.
Walking on my feet all night moving, twisting, bending, and squatting at work unloading trucks and restocking the sales floor at a retail store it’s important that I maintain a healthy range of motion having properly fitted shoes and not over exerting myself using poor posture and these are a great supplementary tool to help ensure that I’m doing that.
👍👍
Honstly. This is THE BEST examination video. The best part is that you included an illustration about the abnormalities. Keep going please 🙏🏻
Love the videos Dr. G. Please keep them coming! Thank you!
I’ve the Knee anatomy in planning atm
Love the bloopers you added. Great video Dr.
I came here for ASMR and some light learning and now I'm much more interested in kinesiology. Thank you, Dr. Gill & Co.!
Fantastic for me as a nurse, forever learning from your channel Dr. Gill. These examinations fascinate me.
😊 thanks 😊
Which area in nursing are you?
Megan is back, yay!
Funny I've been reading medical reports for years talking about Trendelburg tests etc and I never actually knew what they meant (don't worry, I'm not a doctor or allied health professional). This has been very enlightening.
That’s a great thing to hear! I love it when things come full circle like that 😊
You are the man !!! The 🐐 of doctors💪🙏🔥
6:58 Dr Saul would be proud. You MUST ALWAYS check the leg lengths.
I don't work in a medical field, but these videos interest me. Plus, they improve my knowledge of anatomy!
thanks for joining us 😊
Very helpful to have the model demonstrate the movements of a patient with deficiencies. And of course to help we tingleheads. Thank you.
SOME of the simple muscular changes are easy to demo, I’m going to try and add a few more in I think
Great video, very informative. Thanks to you both for this.
👍
This is the world's greatest man
As someone who always had to have his mom go with him to doctors appointments just so someone could explain what was happening, these have been really helpful for making me not dumb
I’ve been surprised at the patient responses with the videos/ glad they are helpful 😊
You made it so so so so simple!!!!!!!
This is the best! Thank you!!!
I’m not even planning on going to med school I’m planning to go to veterinary med school but your videos are so interesting and cool!
In times of war vets can work as medics. We cant work as vet! 😊
This new patient is so chaotic I love her
she looks really uncomfortable
First class as always, Dr. Gill 👌 You're a great teacher, my friend. Cheers from Niagara 🇨🇦 ✌️
It’s spelled Nigeria 🇳🇬
@@andrewalllport4089 seeing as they've put the Canadian flag, and Niagra is a municipality in Canada, I'm pretty sure they know where they live!
@@kiarona. it’s a joke
Awesome detailed video doc! Didn’t want the video to end
👍
very awesome video, it shows what you would see if you encounter a positive diagnosis and not just a negative diagnosis. of course, the asmr is a plus, however the video color inconsistency and multiple jump cuts is a bit distracting, but doesnt take away from the high value of the content. Megan as patient is also lovely.
I’ve seen a couple of comments - I think my colour-blindness got the better of me on this one
@@DrJamesGill oh right I forgot about that, that explains alot
Another excellent piece of craft from you good sir
Thank you. These longer ones are a challenge, but I think worth it 😊
Awesome video! Learned a lot
Great to hear! How do you think we could improve?
Another great video! I would recommend however, to manually set your camera's white balance as it seems to change between scenes on an auto setting. Loving the new editing!
Thanks. That’s a good point. I’ll try it
I love the mad grading on this video. It's psychedelic!
I think it’s a symptom of my colourblindness!
Great, relaxing, informative video. Thanks. Weird side note: This patient looks like the real life version of Aloy from the Horizon video game series to me.
Lighting is a bit inconsistent in this one (white balance maybe?), but still an interesting and informative video. I like how you all demonstrate what a positive result of the tests look like, if that makes sense.
Thanks, Dr. Gill and Megan!
Yes colours seem to have had me here. I *thought* something was slightly off, but couldn’t really be sure - now we know
@@DrJamesGill Now we know
@@DrJamesGill Two potential solutions here for future vids.
Either: make sure your camera white balance isn’t set to ‘auto’ (otherwise it will change with the light - eg if the sun is in and out of clouds - but won’t look consistent if/when you cut footage together), OR use colour balance picker tool in colour menu of your editing program (use picker to click on white background and editor should then adjust colour to make everything back to “normal” since it now knows what surface is supposed to be white).
If you go for the first option, just play with the white balance presets on your camera until you get an image close to what your eye sees. If it’s not exact, you can always use method 2 to correct in the edit - and at least you’ll only have to do that once (as footage should all be the same colour).
@@joshuavincent7884 how is that not distracting? its pretty obvious and takes away from the experience.
you should get your eyes checked
Well explained, thank you so much..
Glad it was helpful!
Thank you for the revision. :))
I'm not sure if it's in purpose but your videos are very relaxing and ASMR like.
Yes. Dr gill is an asmr legend on RUclips
I'm really thankfull for the knowledge you share with us.
It has helped me to be more aware and thankfull that i'm a healthy and a caring "body owner" (probably my encephale talking here idk..😅)
The quality of the content is also getting better and wider on every topic. i really had to appreciate that.
Thank you Doc! hope you will continue to enlight me with medical science for has much has you enjoy sharing it !
I wish you the best,
Signed a knowledge seeker
P.s. the bed part with the pause and the laughter was a nice addition to keep in 😁👋👋
It’s a slow journey, but I think I’m getting the hang of it
Hi there! I am a follower and watch for ASMR, but I was recently told I have sacroilitis, not sure I spelled that correctly, and was hoping you would have mentioned it since I'm told it affects the hip, pelvic area and makes it very painful and difficult to walk. Do you have any archive videos discussing this issue by chance? Thank you 😊
That was the part where we pressed down on the pelvis to stress the SI joint - as the sacroiliac joints become inflamed with sacroilitis 😊
the legend himself
Doctor James 🤩
wow i love these videos! informative and comforting!
👍
His voice is so soothing and he is so cute.
Sus
@@donkeydonk127 Why "sus"?
I'd love if you could do a video on how you handle difficult patients - mostly how you don't let it affect you and maintain your mental health as a clinician. I've worked in admin in a GP surgery and a hospital and I don't know how the clinical staff can stand dealing with difficult patients back to back all day long. Even if it's only 1 or 2 rude entitled people in a day, it must grate on you surely?
perhaps, it's a difficult topic however
I started watching these to fall asleep easier and now I'm addicted :)
Knowledge for the win 😊
Even though I’m not a doctor, I’ve spent enough times in hospital and certainly got my moneys worth out of the NHS. I find all of these videos by Dr Gill interesting
Hopefully you have found they helped you understand your body a little better?
@@DrJamesGill yeah. I do have an interest but I’m not clever enough for medical school
I feel like a doctor watching these. Then reality hits at end of video.
I'm glad to see that Han Solo settled down and got into medicine.
Is there any chance that you might do a video about migrane and cluster headaches? I think a lot of people would be interested in it.
It’s on the list, along with a few other things. 😊
Not just that you wonderfully explains the stuff but the charisma you have while delivering it is exceptional. Great work. #bigfan .
What's up doc?
Doc be like:- let's put a bit of paper. 🥰🥰. Master ASMR too. One and only doctor Gill.❤
Nice video
Just here for the ASMR. However, I find myself wondering is the right shoulder slightly lower than the left?
Thankssss❤
I need a compilation of Dr Gill bloopers. Problem is I don't think he makes mistakes
Have you ever said your opinions on chiropractic work? A lot of what you went over in this video is stuff I've seen chiropractors like Dr Gregory Johnnson and Dr Brent Binder discuss in their adjustment assessments.
Physiotherapy is very good, and supported by research and evidence.
Your videos are life saving. Sir, could you please complete the history taking series as well? Thank you so much
I will try my best
Great, informative video as always but;
How did you get Zosia Mamet on your Channel?
are you serious?😂
@@nhummm No.
11:26 "Having done our..." *noise* "Having broken the bed" XD
Well, if your patient decides on a career in pro-wrestling, the MC could introduce her as - "Megan 'The Bedbreaker' Struthers".
Bed breaker…whadda mean by that brother
I had to have both my hips replaced because of a tear in something
I don’t know what I did on the first hip to cause a tear but the second one I was stepping over a puddle getting into my car and knew immediately something happened (based on my first hip replacement)
The replacements were the best thing ever. I was a runner for years but as I age running turned into walking
It’s amazing what the orthopods can do. Was that a labral tear?
Can you please recommend anyone in the US that would be a thorough as you?
Thank you, I have a problem in that area, if I sit at a desk my groin area about waistline burns about skin deep. But if I use a stand up desk the goes much deeper into the hips. Had it 6 months now.
She is a regular, good to see her more.😅😊
Hello, Dr. Gill. What exercises would you recommend for weak hip flexors and tight iliopsoas?
Honestly, I’d recommend a review with a physio. Whilst I have working knowledge of the musculature, when it comes to rehabilitation, you want to get advised by the experts - physio
I have no use or application for any of this information since I'm a magnet sculptor and writer but it's midnight right now and I'm doing everything I can not to break my twenty month clean streak from my brutal self-mutilation addiction. I just like feeling as though someone is speaking to me, it keeps me from just screaming into the void.
maybe you could talk about how to bring up / address self harm scars (like my train track arm) when first meeting or examining a patient? I've had doctors be extremely kind and others be profoundly rude about them. it occurs to me that there probably isn't any training in this area and doctors are caught just as off guard as strangers who see my scars when I'm out shopping or at the gym except the doctor now has to talk to me and the awkwardness is more impactful to me as a person.
I’m sorry you’ve had this to deal with.
Are you getting help from your doctor?
When I’m unaware of the situation, I deal with it the same way I would as an unexpected rash “can you tell me about this please?” and carry on from there
@@DrJamesGill I'm actually getting shots inside the more hardened ones which is making them flatter and helping the itching.
that's nice that you do it like that. I still don't like when people ask about mine, even my therapist doesn't really make me talk about those days. it's _such_ an addictive habit. it gets life / limb threatening quickly.
Bro getting me through med school singlehandly (i dont go to med school)
I guess you could say, you gotta be "hip" to reach the young ones
Also, may I ask how are your hips and is there a good way to keep them in check?
Keeping active, and a health weight is probably best advice for hip - and ensuring your shoes are appropriate
@@DrJamesGill I'll be sure to make sure I'm doing a majority for when I'm active!
Thank you James!
When my daughter was born they said she had hip dysplasia. This was diagnosed just after birth. She had a "harness" that she had to wear and we were given instructions on how to exercise her legs and hip. I believe we only did this for the first year of her life. She is now 19 and notices some uncomfort with her hips.
That’s a Plavic harness and they look almost medieval - but they work
If she is having difficulties, it would be worth talking to her GP she may need a chat with a specialist 😊
Oh I had one of these as a baby!! I keep getting told my hips should be better than normal now but they keep pulling out slightly. Glad I'm not alone!!
11:23 😂😂
I think that should have been edited out! 😅
I'm glad you haven't edited it out, it made me giggle 😂
@@DrJamesGill it does briefly break ASMR but I think seeing this occasionally is quite funny. A blooper reel compilation now and again would be a great addition
Doctor Gill is cute and adorable
Megan looked really worried when you said it's not just a concern for older people 😂 0:17
You may be surprised how often young sports people injure their hips
@@DrJamesGill Buster Posey , a well known All Star catcher for the San Francisco Giants had hip problems that eventually ended his baseball career last year . National Hockey League players here in North America and Canada are allowed to hit or " check " an opposing player by ramming their shoulder into the other player's hip to get them to " straighten up " .
Have my first osce exam in two weeks. Wish me luck and any advice anyone has for me?
Good luck! Anything we can help with in the run up?
@@DrJamesGill yes actually!! A video on how to read abdorminal and chest x rays with their common findings and their associated conditions would be very much appreciated!!
We’ve got you sorted for a basic approach to CXR, two weeks might be a bit tight for an AXR, but I’ll put it on the list
-Please, relax
-I am relaxed
-I'm talking to myself
Megan during intro : *thinking* “what a splendid wall”
🤣
this video is making me realize why i’m studying law 😂 would never be able to remember all the terminology 😂
Actually I’ve been told law and medicine have a similar level of vocabulary to learn.
İ wish i can understand i need improve my English but i like accent and your soft speaking make me a sleepy 😴😴
I'm 41 and cant lay on my hip,its do painful,its been like it for months.My mum and her sister both have osteoporosis
hey doctor doctor how are you today
Definitely plenty of hips to observe on this patient
I know that it's crazy
I know that it's nowhere
But there is no denying that
It's hip to be square
Wish physio actually did this instead they just ask you 5 questions and not diagnose you and just throw you some basic exercises from the printer. Even if they don't know what's wrong
Is it true you're the on set doctor for GI Jane 2?
James Gill you're the fucking man
I hope not, the GMC might want to ask James a few questions about it 😂
@@markfizz2012 Mark Fizz you're the fucking man
Having done our (stares ) having broken the bed ) 😂😂😂😂😂
Yes that slipped through the edit.
Would fire the editor, but that would cause problems
@@DrJamesGill noooo, give him a raise instead.
@@DrJamesGill glad it slipped through
I'm 29 and my hip has been screwed up since 24 working at USPS and my knee..and my ankle...and my shoulder..my hand goes numb some times..
Sounds like something in the kinetic chain throwing everything off.
You need to see your GP to have that looked at
@@DrJamesGill After watching your video I'm going to. Thank you Dr. Gill.
I really need to find out if my right leg is longer. When I'm rowing feels like my right is doing all the work and at the end of the stroke my left foot lifts off the foot support as if it's shorter.😞
Easy to measure - just as a friend with a tape measure, and follow as in the video
Up to ~ 7-8mm difference is within normal for true leg length
I had similar when I rowed at Warwick, I needed inner soles to fix 😊 - but never made it to the first Viiii though 😞
@@DrJamesGill Yeah it's weird, feels like my left leg has pushed as much as it can but the right is still going.😀
This is the 2022 equivalent of reading an encyclopedia in bed
Interesting take!
How Tall are you James, which specialty did you finish?
I’m trained as a GP - so I know a little about a lot, but not a lot about many things
A Jack of all trades is a master of none, but often times better than a master of one
Hope the bed still ok... These are not times to spend money in new beds, gotta learn to repair them
Touch and go, but it survived
(As a patient) Can you do anything about that Anterior Tilt? I’ve got that and it causes me lower back problems
Doc
THIC CHAIN
Me with severely messed up pelvic/abdominal/hip muscles: [rubbing hands] oh boy
(I did go to pt to increased flexibility and decreased pain though!)
Physio is brilliant😊