Squaring the pelvis is achieved by first placing the hips and knees in extension (e.g. patient in supine lying). Both ASIS are thereafter aligned to the same height i.e. to the same level with each other and parallel to the edge of the plinth/table. In children, the pelvis can be fixed by palpating both ASIS with one hand span. In adults, the pelvis can be fixed with the forearm while the other hand is used to measure or move the leg of interest. [1] Leg length discrepancy (LLD) or anisomelia, is defined as a condition in which the paired lower extremity limbs have a noticeably unequal length. Clinical measurement of both lower limbs using referenced anatomical landmarks may reveal: Structural (SLLD) or anatomical discrepancy i.e. differences in leg length resulting from inequalities in bony structure or Functional (FLLD) or apparent discrepancy i.e. unilateral asymmetry of the lower extremity without any concomitant shortening of the osseous components of the lower limb.
Pelvic obliquities associated with LLD include:
A – Pelvis is level with symmetrical stance (no LLD).
B – Pelvis is not level with symmetrical stance (uncompensated LLD).
C – Pelvis is level with asymmetrical stance (compensated LLD).
D – Pelvis is not level with asymmetrical stance (partially compensated LLD, contractures). [2]
Will gives additional insight in his related video ‘Supine to sit test’. I highly recommend the video.
Reference 1: Rex C. Clinical Assessment and Examination in Orthopedics. 2nd edition, 2012. Jaypee Brothers Medical Publishers (P) Ltd. Pg 142., Reference 2
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