By Dos Winkel
Clinical Society of Flemish normal Practitioners, Antwerp, Belgium. Translation, variation, and compilation of 3 titles formerly released in Dutch. Halftone illustrations. 7 participants, three U.S. DNLN: Leg.
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Extra info for Diagnosis and Treatment of the Lower Extremities: Nonoperative Orthopedic Medicine and Manual Therapy
Patients complaining of pain in this area often have a history of overtraining or excessive sitting. Deep pres sure can be effectively used to localize the most painful spot. In most instances, this will be the location of a bursa. The ischial bursa of the gluteus maximus is found between that muscle and the most cra nial part of the ischial tuberosity. The tro chanteric bursa is located between the greater trochanter and the gluteus maximus muscle. Pain in the buttocks is often a sign of hip disorders.
At the same time, the hip of the Figure 2-9 Palpation of the edge of the adductor longus muscle. Surface Anatomy of the Hip 19 stance leg shifts outward. The patient ap pears to "hang" in the lateral ligaments of the affected hip joint. This visible symptom is called the Trendelenburg sign. The gluteus minimus muscle is completely covered by other muscles and cannot be pal pated. Adductor Longus Muscle During resisted adduction of the leg, a round cord is visible and palpable distal to the pubic tubercle.
Palpation of the sartorius should be per formed from proximal to distal using alternat ing pressure from two fingers. The index and middle fingers are placed at either side of the muscle in a longitudinal direction. During movement in the distal direction, the fingers should apply varying amounts of pressure. To understand positioning of the sartorius muscle behind the femoral condyle, refer to Chapter 8. The pes anserinus is easily visible in thin people, but it is not possible to differ entiate among the sartorius, gracilis, and semitendinosus muscles because they attach via the pes anserinus to the tibial tuberosity.
Diagnosis and Treatment of the Lower Extremities: Nonoperative Orthopedic Medicine and Manual Therapy by Dos Winkel
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