Which hip sign in tuberculosis of the hip indicates flexion-adduction-external rotation contracture — the hip is held in the position that maximises joint capacity and minimises pressure?

• A Trendelenburg sign
• B Thomas test posture
• C Telescoping sign
• D Sign of the rising sun (Nelson's sign) ✓

Explanation

In tuberculosis of the hip, the joint capsule is maximally relaxed when the hip is held in flexion, abduction, and internal rotation (flexion-ABduction-internal rotation in early stage). As the disease progresses and destroys cartilage, the hip adopts a flexion-adduction-external rotation position — the attitude of maximum joint capacity. The 'sign of the rising sun' (Nelson's sign) describes the appearance of the femoral head subluxating superiorly and laterally as the acetabulum is destroyed, visible on AP pelvis radiograph. The Trendelenburg sign reflects abductor weakness.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.