limits eversion and adduction. The weakest
part of the capsular ligament lies opposite the lower and back part of
the joint.

The hip-joint is surrounded by muscles which contribute to its
strength, the most important from the surgical point of view being the
obturator internus, which plays an important part in certain
dislocations, and the ilio-psoas, which influences the attitude of the
limb in various lesions in this region.

Except in thin subjects, the constituent elements of the hip-joint
cannot be palpated through the skin. A line drawn vertically downwards
from the middle of Poupart's ligament passes over the centre of the
joint, which in adults lies on the same level as the tip of the great
trochanter. In children it is somewhat higher.

For purposes of clinical diagnosis it is necessary to locate certain
bony prominences, the most important being--(1) The _anterior superior
iliac spine_, which is most readily recognised by running the fingers
along Poupart's ligament towards it. (2) The _ischial tuberosity_,
which in the extended position of the limb is overlapped by the lower
margin of the gluteus maximus muscle, and is therefore not easily
located with precision. By flexing the limb and making pressure from
below upwards in the gluteal fold, the smooth, rounded prominence can
usually be detected. (3) The quadrilateral _great trochanter_ is
readily recognised on the lateral aspect of the hip. Its highest point
or _tip_ can best be felt by pressing over the gluteal muscles from
above downwards.

_Clinical Tests._--If a line is drawn from the anterior superior iliac
spine to the most prominent part of the ischial tuberosity, it just
touches the tip of the great trochanter. This is known as _Nelaton's
line_ (Fig. 58).

[Illustration: FIG. 58.--Nelaton's Line.]

_Bryant's test_ (Fig. 59) is applied with the patient lying on his
back, and consists in dropping a perpendicular AB from the anterior
superior iliac spine, and drawing a line CD from the tip of the great
trochanter to intersect the perpendicular at right angles. This is
done on both sides of the body, and the length of the lines CD
compared. Shortening on one side indicates an upward displacement of
the trochanter, lengthening a downward displacement. The third side AC
of the triangle indicates the distance between the anterior spine and
the tip of the trochanter.

[Illustration: FIG. 59.--Bryant's Line.]

_Chiene's test_, which is simpler tha