{"id":1198,"date":"2010-12-04T14:45:04","date_gmt":"2010-12-04T14:45:04","guid":{"rendered":"https:\/\/cloverock.info\/mockosce23\/new\/tests-if-a-difference-in-leg-length-is-suspected\/"},"modified":"2024-01-10T16:43:35","modified_gmt":"2024-01-10T16:43:35","slug":"tests-if-a-difference-in-leg-length-is-suspected","status":"publish","type":"post","link":"https:\/\/www.qpercom.com\/sim\/index.php\/the-examination-of-the-lower-extremities\/the-pelvic-girdle\/tests-if-a-difference-in-leg-length-is-suspected\/","title":{"rendered":"Tests If A Difference In Leg Length Is Suspected"},"content":{"rendered":"<hr \/>\n<p><span style=\"color: #003366;\">These tests are indicated in the case of:<\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">Observed <span style=\"color: #33cccc;\"><strong>pelvic asymmetry<\/strong><\/span> and <span style=\"color: #33cccc;\"><strong>functional scoliosis<\/strong><\/span> and\/or <span style=\"color: #33cccc;\"><strong>abnormal knee fold height<\/strong><\/span> upon inspection.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong>General Impression Of Leg Length<\/strong><\/span><\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/124602476?dnt=1&amp;app_id=122963\" width=\"640\" height=\"480\" frameborder=\"0\" allow=\"autoplay; fullscreen; picture-in-picture\"><\/iframe><\/p>\n<hr \/>\n<h3><span style=\"color: #003366;\">Procedure<\/span><\/h3>\n<ul>\n<li><span style=\"color: #003366;\">The patient lies on the examination table in <span style=\"text-decoration: underline;\">supine position<\/span>, with both hips and knees in <span style=\"color: #33cccc;\"><strong>90\u00b0 flexion<\/strong><\/span>.<\/span><\/li>\n<li><span style=\"color: #003366;\">The examiner supports the lower legs and stands at the side\/foot end of the examination table<em><strong> [Figures 44a, 44b]<\/strong><\/em>.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1195\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/LowerExtrem_le-fig-44a.jpg\" alt=\"\" width=\"400\" height=\"295\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/LowerExtrem_le-fig-44a.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/LowerExtrem_le-fig-44a-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 44a<\/span><\/strong><\/span><\/p>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1196\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/LowerExtrem_le-fig-44b.jpg\" alt=\"\" width=\"400\" height=\"294\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/LowerExtrem_le-fig-44b.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/LowerExtrem_le-fig-44b-300x221.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 44b<\/span><\/strong><\/span><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\"><span style=\"text-decoration: underline;\">Note<\/span> a<\/span><span style=\"color: #003366;\">ny difference in knee height (<em>difference in length of upper legs<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Ask the patient to lie in <span style=\"text-decoration: underline;\">prone position<\/span>, with both knees in <span style=\"color: #33cccc;\"><strong>90\u00b0 flexion<\/strong><\/span>. <\/span><\/li>\n<li><span style=\"color: #003366;\">The examiner stands at the foot end or at the side of the examination table <em><strong>[Figure 45]<\/strong><\/em>.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span class=\"jce_caption\" style=\"display: inline-block; color: #003366;\"><img loading=\"lazy\" decoding=\"async\" class=\" size-full wp-image-1197\" style=\"margin: auto;\" src=\"https:\/\/cloverock.info\/mockosce23\/new\/wp-content\/uploads\/2010\/12\/LowerExtrem_le-fig-45.jpg\" alt=\"\" width=\"400\" height=\"293\" srcset=\"https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/LowerExtrem_le-fig-45.jpg 400w, https:\/\/www.qpercom.com\/sim\/wp-content\/uploads\/2010\/12\/LowerExtrem_le-fig-45-300x220.jpg 300w\" sizes=\"auto, (max-width: 400px) 100vw, 400px\" \/><strong><span style=\"width: 400px; display: block;\">Figure 45<\/span><\/strong><\/span><\/p>\n<hr \/>\n<ul>\n<li><span style=\"color: #003366;\"><span style=\"text-decoration: underline;\">Note<\/span> a<\/span><span style=\"color: #003366;\">ny difference in the height of the soles of the feet (<em>difference in lengths of lower legs<\/em>).<\/span><\/li>\n<\/ul>\n<hr \/>\n<p><span style=\"color: #003366;\"><strong>Plank Test<\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #003366;\">The patient stands up straight, with knees extended as far as possible and feet next to each other. <\/span><\/li>\n<li><span style=\"color: #003366;\">Examiner stands behind the patient.<\/span><\/li>\n<li><span style=\"color: #003366;\">One or more blocks of different thicknesses (<em>0.5, 1.2 or 3 cm<\/em>) are placed under the leg that is too short.<\/span><\/li>\n<li><span style=\"text-decoration: underline;\"><span style=\"color: #003366; text-decoration: underline;\">Note<\/span><\/span> <span style=\"color: #003366;\">whether the pelvis (<em>iliac crests and posterior superior iliac spine<\/em>) lies in a horizontal position (<em>both knees extended<\/em>).<\/span><\/li>\n<li><span style=\"color: #003366;\">Assess by how many centimetres the heel needs to be elevated for a horizontal position of the pelvis to be achieved. <\/span><\/li>\n<li><span style=\"color: #003366;\">Inspect and\/or palpate the pelvis on both the <span style=\"color: #33cccc;\"><strong>ventral<\/strong><\/span> and <span style=\"color: #33cccc;\"><strong>dorsal sides<\/strong><\/span> (<em>eyes level with pelvis<\/em>). <\/span><\/li>\n<li><span style=\"color: #003366;\">If after correction the height of the knee folds is the same, when this was not the case before, the <span style=\"text-decoration: underline;\">difference<\/span> in length lies in the <span style=\"color: #33cccc;\"><strong>lower leg<\/strong><\/span>.<\/span><\/li>\n<li><span style=\"color: #003366;\">If the pelvic asymmetry persists, this may possibly be due to <span style=\"color: #33cccc;\"><strong>muscle contractures<\/strong><\/span>.<\/span><\/li>\n<li><span style=\"color: #003366;\">Assess the effect on the spine (<em>disappearance of the scoliosis<\/em>). <\/span><\/li>\n<li><span style=\"color: #003366;\">If the scoliosis persists, this is referred to as <span style=\"color: #33cccc;\"><strong>structural scoliosis<\/strong><\/span>.<\/span><\/li>\n<li><span style=\"color: #003366;\">Correlate the findings with the position of the spine by having the patient sit on a stool with their back facing the examiner. <\/span><\/li>\n<li><span style=\"color: #003366;\">In the case of <span style=\"color: #33cccc;\"><strong>functional scoliosis<\/strong> <\/span>based on a difference in leg length, the curvature should disappear in the sitting position as the difference in leg length has no effect in this position.<\/span><\/li>\n<li><span style=\"color: #003366;\">This method has an <span style=\"color: #33cccc;\"><strong>interobserver standard deviation<\/strong><\/span> of about 0.5 cm. <\/span><\/li>\n<li><span style=\"color: #003366;\">The most reliable method remains <span style=\"color: #33cccc;\"><strong>radiographic measurement<\/strong><\/span>. <\/span><\/li>\n<li><span style=\"color: #003366;\">Correction for a difference in leg length of between 1.5 and 4 cm can usually be adequately resolved using conservative measures (<em>e.g. elevated shoes<\/em>), with which the entire difference, as measured by the block test, is corrected for. <\/span><\/li>\n<li><span style=\"color: #003366;\">Differences in leg length of <span style=\"color: #33cccc;\"><strong>&lt; 1.5 cm<\/strong><\/span> are usually only corrected in the case of athletes.<\/span><\/li>\n<\/ul>\n<hr \/>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>These tests are indicated in the case of: Observed pelvic asymmetry and functional scoliosis and\/or abnormal knee fold height upon inspection. General Impression Of Leg Length Procedure The patient lies on the examination table in supine position, with both hips and knees in 90\u00b0 flexion. The examiner supports the lower legs and stands at the [&hellip;]<\/p>\n","protected":false},"author":83,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[69],"tags":[144],"class_list":["post-1198","post","type-post","status-publish","format-standard","hentry","category-the-pelvic-girdle","tag-the-examination-of-the-lower-extremities"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Tests If A Difference In Leg Length Is Suspected - Qpercom | Skills in Medicine<\/title>\n<meta name=\"description\" content=\"Online Mock OSCEs with examiners, patient actors, instant results and personalised feedback. 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