Physical Exam

Hip Passive Range of Motion

🎬

Video coming September 2026

How to Perform

With the patient supine and relaxed, move the hip passively through flexion, abduction and adduction, and internal and external rotation (with the hip and knee flexed), comparing sides. Note the range, the end-feel, and any pain or restriction, comparing with the active range. With the opposite hip held fully flexed to flatten the lumbar spine, extend the tested hip and note whether it stays flexed off the table.

How to Interpret

Hip Osteoarthritis

Reduced range of passive hip adduction, compared with the other side or measured with a goniometer

Rule in

Somewhat helpful

Rule out

Somewhat helpful

Evidence:Strong

Reduced range of passive hip internal rotation (and/or pain at the end of internal rotation), tested with the hip and knee flexed and compared with the other side or measured with a goniometer

Rule in

Somewhat helpful

Rule out

Somewhat helpful

Evidence:Strong

References

Metcalfe D, Perry DC, Claireaux HA, Simel DL, Zogg CK, Costa ML. Does This Patient Have Hip Osteoarthritis?: The Rational Clinical Examination Systematic Review. JAMA. 2019 Dec 17;322(23):2323-2333. doi:10.1001/jama.2019.19413. PMID 31846019.
Vigotsky AD, Lehman GJ, Beardsley C, Contreras B, Chung B, Feser EH. The modified Thomas test is not a valid measure of hip extension unless pelvic tilt is controlled. PeerJ. 2016 Aug 11;4:e2325. doi:10.7717/peerj.2325. PMID 27602291.
Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.