In tuberculosis of the hip joint, which clinical sign refers to apparent lengthening of the limb in early disease due to adduction deformity of the hip?

• A Trendelenburg's sign
• B Telescoping sign
• C Anvil test
• D Thomas's hip flexion test ✓

Explanation

Thomas's hip flexion test is used to unmask a fixed flexion deformity of the hip that the patient compensates for by increasing lumbar lordosis. In early TB hip, a flexion–adduction–external rotation deformity develops; the adduction component causes apparent lengthening (not shortening). Thomas's test eliminates the lumbar compensation and reveals the true fixed flexion. Apparent lengthening from adduction deformity is an early, important clinical sign of hip TB.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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