In tuberculosis of the hip joint, the classical deformity seen in the early active phase is described as flexion, adduction, and internal rotation. This position is adopted because:

• A Maximizing hip joint capacity reduces intra-articular pressure and relieves pain ✓
• B Spasm of hip flexors and adductors relieves intra-articular pressure
• C Internal rotation is due to posterior capsular contracture
• D Gravity pulls the limb into adduction and internal rotation

Explanation

The hip joint's capacity is maximized at approximately 30° flexion, 30° abduction, and slight external rotation — but in early TB hip, the inflamed joint adopts the position of maximum synovial capacity (some flexion and abduction) to accommodate the increased fluid and reduce pain. As disease progresses and fibrosis sets in, the 'position of comfort' becomes fixed contracture. The apparent adduction is often due to pelvic tilt compensating for abductor weakness or pain — not true adduction at the joint level initially. Understanding the synovial joint capacity concept is important for examination questions.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.