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Trendelenburg's sign

Trendelenburg's sign is observed in people with weak or paralyzed hip abductor muscles, mainly the gluteus medius and gluteus minimus.

The patient is made to stand or balance first on one leg and then on the other. As the patient is balancing on one leg, the examiner observes the movement of the pelvis. If the pelvis on the side of the non-stance leg rises, the test is considered negative, because the gluteus medius muscle on the opposite (stance) side lifts it up as it normally does in one-legged stance. If the pelvis on the side of the nonstance leg falls, the test is considered positive and is an indication of weakness or instability of the hip abductor muscles, primarily the gluteus medius on the stance side. Therefore, although the examiner is watching what happens on the non-stance side, it is the stance side that is being tested.

Relevant anatomy of the Gluteus Medius Muscle

This muscle arises from the outer surface of the ilium, over an area just behind (or posterior to) the gluteus minimus. It too is fan shaped but thicker and broader than the minimus. In descending it narrows to form a tendon which attaches on the greater trochanter just behind and above where the gluteus minimus muscle inserts.