The doctor will watch you walk to observe unevenness or changes in your gait. Hip pain or muscle weakness can change how you walk. Speak up if any portion of your stride hurts. The doctor may examine your shoes for signs of abnormal wear. He or she will observe how far you can flex your knee toward your chest and extend your leg out behind you, and how readily you can move your leg out to the side (abduction) and across your midline (adduction). As you lie on your back, the doctor will measure how far you can rotate your hip externally (letting the knee fall toward the outside of your body) and internally (letting your knee turn toward your midline). As you move or try to resist pressure applied by the doctor during different maneuvers, the doctor will assess pain, muscle strength and restrictions, and any grinding or snapping in the joint.
Along with the hip exam, the doctor will examine the position of your pelvis, compare your leg lengths, test nerve function in your legs, and check your feet and ankles for swelling that might indicate impaired circulation. He may ask you to simulate putting on socks with a figure of four position of the leg. Lack of motion in the hip may indicate degenerative hip disease. He or she will also examine your spine for curvatures or conditions (such as a pinching of the sciatic nerve) that can cause hip pain.
In addition, the doctor is likely to use x-rays, magnetic resonance imaging (MRI), or an MRI arthrogram (an imaging technique in which an iodine-based dye is used to enhance the resolution of the MRI) to diagnose hip problems.