Physical examination maneuver
Waist-to-hip Ratio
How to Perform
With the patient standing, expose the waist landmarks by lifting the shirt and lowering the waistband slightly. Have the patient stand upright with the feet together, arms relaxed at the sides, and abdomen relaxed. Using a flexible, nonstretchable tape, measure the waist circumference directly on skin at the midpoint between the lower margin of the last palpable rib and the top of the iliac crest. Keep the tape horizontal and snug without compressing the skin, and record the measurement at the end of a normal expiration. Then have the patient slide the pants down to the upper thighs and measure the hip circumference over the underwear around the widest portion of the buttocks, keeping the tape horizontal and snug without compressing the underlying tissue. Record both measurements in the same units and calculate the waist-to-hip ratio by dividing the waist circumference by the hip circumference.