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10 9 8 7 6 5 4 3 2 1 After subjective interview for history and symptoms starts the physical examination. Is important to watch the patient since he cames in the clinic: any limp? Does he use crutches? Can he sit?. Than start the physical examination: standing and tests. Objective observation. Palpation: tenderness at the hip, pain and sensitivity over great trochanter. ROM: normally painful at the end of available range of motion early signs of osteoarthritis is limited abduction and rotation. As the the disease progresses, flexion, extension and adduction becomes more difficult. In cases of severe O A, the range of motion can be severely limited either mechanically or due to pain. Crepitus can be palpable while moving the joint. Rotational movements, namely internal rotation, usually reproduces the patient’s symptoms and is generally accepted as a good localizing test by surgeons. Thomas’ test reveals a fixed flexion deformity (which limits extension) and Trendelenburg test is performed to assess the strength of the gluteal muscles (abductors). Hip osteoarthritis can be diagnosed by clinical presentation only, but special investigation are vital to monitor the progression of the disease. X-Ray: Findings include jpint space narrowing, marginal osteophytes, subchondral sclerosis and bone cysts. This is normally the first investigation done that aids in the diagnosis of hip osteoarthritis. MRI: More effective in detecting early change in the bone structure, such as focal cartilage defects and bone marrow lesions in the suchondral bone CT scan X-ray imaging is still the gold standard for investigating patients with osteoarthritis of the hip. It is an easily accessible and economical modality available worldwide. Progressive cartilage destruction leads to narrowing of the joint space. Subarticular cyst formation. Sclerosis of the surrounding bone. Capsular fibrosis. Bone remodelling.