Inspection of the region revealed no ecchymosis or
divot deformity. Active, passive and resisted ranges of
motion of the lumbar spine and knee were full and pain
free bilaterally, while right passive hip extension and resisted
hip flexion were limited due to pain. The right
psoas major was tender to palpation as was the proximal
aspect of the rectus femoris. The strength of the psoas
major and rectus femoris were graded as 4/5 using the
Grading Motor Strength Scale, while all other hip and
groin muscles were graded as 5/5 with manual testing.
Muscle testing for rectus femoris was performed with the
patient in lateral recumbent position with the hip extended
and the knee flexed; whereas the testing for psoas major
was performed with the patient supine with the hip
flexed approximately 30°, abducted 10° and externally
rotated.4