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Hip Special Test: Sign of the Buttock

Hip Special Test: Sign of the Buttock is an orthopedic test used to determine whether a patient is suffering from a hip disorder or injury. The test measures the ability of the patient to move their leg to the side and towards the buttock. This test is typically done when a patient complains of hip pain or limited range of motion in the hip. This test is especially useful in helping to diagnose hip pathologies such as inflammatory or degenerative joint disease, meniscus tear

Transcript

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This is Brent of the Brookbush Institute, and in
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this video we're going over the sign of
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the buttock, a very simple test but something everybody should have in their
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repertoire because this is one of those red flag issues. I'm going to have my friend
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Melissa come out she's going to help me demonstrate, and then I will explain what
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the appropriate action is if you find this sign. So the sign of the buttock
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basically goes like this, I was doing a straight leg raise,
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maybe I was doing a straight leg raise to check her hamstring flexibility,
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maybe I was doing a straight leg raise to check if she has sciatic nerve
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symptoms see if I could provoke those symptoms again, maybe checking to see if
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there's something going on with her low back, either way I get up so far and
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then I get stuck. Well me having the ability to
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do some deductive reasoning go, well we want to see if it's either sciatic nerve
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or biceps femoris, the way I could get those two structures out is I could bend
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the knee and this is where things get a little weird. I take those structures out
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which in most people gives them all sorts of hip flexion back, but this time
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I try to get them more hip flexion and nothing; and maybe even with that nothing
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they get a little pain in their backside like around their gluteal fold. This
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is one of those things where you need to take a step back and go what could
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possibly prevent somebody in their hip from getting hip flexion, and this is
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where things get a tad more serious, although you're gonna hide this from
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your client or patient initially. This is where we have to start thinking is this
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a neoplasm, is this an abscess, is this osteomyelitis.
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Is this something potentially very very serious, and you only have one recourse,
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refer out. Now keep in mind it could just be arthritis ,it could just be capsular
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tightness, it could be hip dysfunction from something like a loose
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body blocking you from getting into hip flexion, and all of those things are
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fairly benign and just orthopedic issues that we can help with.
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But because the sign of the buttock can also be related to cancer, infection of
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the bone, avascular necrosis, we have to go okay look it's a little
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weird so we're going to go through today but I want you to set up
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an appointment with your physician soon, okay and let's let's get this hip
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cleared before we start messing around with it; and that's probably about all I
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would tell my client initially. I probably wouldn't go hey that's a sign
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of cancer, don't do that. That is a terrible thing to do to somebody, you
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will have their heart drop. I don't even think I would be like hey this could be
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serious unless they started pushing back at me and saying that they don't want to
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go to their physician, or they're not going to make an appointment with their
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doctor. I'm not even going to mention it's serious, I'm just going to be like hey
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there's a couple things that could be going on with your hip in this
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particular sign that I I can't help you with, so let's make sure your physician
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gets you some imaging and we'll make sure that you're not wasting
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money with me when maybe there's something else that would treat this
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better, and I would just leave it at that. So once again the sign of the
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buttock is essentially hip flexion restriction after you do your straight
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leg raise and bend the knee, it doesn't get better. They may or may not have some
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pain in their buttock, which is why it's referred to as the sign of the buttock.
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It's more that hip flexion restriction that just makes you kind of go -that's
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not normal, and being a red flag issue you're always
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going to refer out. I hope you enjoyed this video and feel free to leave
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questions in the comment section, I know this type of test