II. Indications
- Evaluation of Intoeing
- Evaluation for Medial Femoral Torsion
III. Technique: Measure rotation of hip
- Test both hips at the same time
- Prevents False Positives due to Pelvis rotation
- Child lies supine or prone
- Hips extended
- Knees flexed (dangling over table edge if supine)
- Push ankles away from midline toward table
- Normal medial hip rotation angle <70 degrees
- Push ankles across midline toward other side of table
- Normal lateral hip rotation angle >20 degrees
- Clearly abnormal if less than -10 degrees
IV. Interpretation: Normal hip rotation angles (vary by age)
- Medial rotation (estimate normal as <70 degrees)
- Age 1: 25 to 63 degrees (mean 43 degrees)
- Age 3: 27 to 65 degrees (mean 48 degrees)
- Age 5: 30 to 67 degrees (mean 50 degrees)
- Age 7: 31 to 68 degrees (mean 51 degrees)
- Age 9: 33 to 68 degrees (mean 51 degrees)
- Lateral rotation (estimate normal as >20 degrees)
- Age 1: 40 to 85 degrees (mean 65 degrees)
- Age 3: 39 to 77 degrees (mean 58 degrees)
- Age 5: 30 to 70 degrees (mean 50 degrees)
- Age 7: 28 to 65 degrees (mean 48 degrees)
- Age 9: 26 to 63 degrees (mean 41 degrees)
V. Interpretation: Signs of Femoral Anteversion
- Most of arc of rotation of hip is inward
- Excessive medial hip rotation >70 degrees
- Limited lateral hip rotation <20 degrees
- Clearly abnormal if less than -10 degrees
VI. Other findings on Hip Range of Motion
- Painful asymmetry is a red flag for pathology
- Also test for Congenital Hip Dysplasia
VII. References
- Schmale (2003) AAFP Board Review, Seattle