Thomas test
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| Thomas test | |
|---|---|
| Purpose | To rule out hip flexion contracture & psoas syndrome. |
The Thomas test is a physical examination test, named after the Welsh orthopaedic surgeon, Hugh Owen Thomas (1834–1891), to rule out hip flexion contracture (fixed partial flexion of the hip) and psoas syndrome (injury to the psoas muscle).
The test consists of 3 steps:
- Step 1: The patient lies supine on the examination table, holding their knee to their chest. The clinician passes the palm of her/his hand beneath the patient's spine to identify lumbar lordosis.
- Step 2: The "unaffected" hip is flexed until the thigh just touches the abdomen to obliterate the lumbar lordosis. The pelvis should be in neutral tilt (not tilted anteriorly or posteriorly).
- Step 3: The clinician then passively ranges the affected hip into extension. Once the pelvis begins to tilt anteriorly, stop the passive range of motion, hold the affected thigh in this position, and measure the angle between the affected thigh and table to reveal the fixed flexion deformity of the hip.
It is important to control the pelvic tilt to ensure that the Thomas test is valid for evaluating peak hip extension angle.[1]
