The patient lies supine on the examination table and brings one knee in direction to the chest/ flexes hip, while the other leg remains extended. The Thomas test is said to be also positive if the patient's
- opposite/ contralateral hip flexes without knee extension- tight iliopsoas
- hip abducts during the test- tight tensor fascia latae
- knee extension occurs- tight rectus femoris
 The hip flexion contracture is physiologic in the first 3 months of life and if it is absent in this period it may be a sign of developmental dysplasia of the hip. It is used to identify unilateral fixed flexion deformity of the hip.
The test consists of 3 steps:
- Step 1: the patient lies supine on the examination table. The clinician passes the palm of his hand beneath the patients spine to identify lumbar lordosis.
- Step 2: The "normal " hip is flexed till the thigh just touches the abdomen to obliterate the lumbar lordosis.
- Step 3: measure the angle between the affected thigh and the table to reveal the fixed flexion deformity of the hip.
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- Musculoskeletal Examination, 2nd edition (2002), chapter 11, p. 327