/clinical/,/clinical/cckm-tools/,/clinical/cckm-tools/content/,/clinical/cckm-tools/content/questionnaires/,

/clinical/cckm-tools/content/questionnaires/name-97095-en.cckm

201605147

page

100

UWHC,UWMF,

Tools,

Clinical Hub,UW Health Clinical Tool Search,UW Health Clinical Tool Search,Questionnaires

Non-Arthritic Hip Score

Non-Arthritic Hip Score - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Questionnaires


/0/"35)3*5*$�)*1�4$03&�
*/4536$5*0/4�� 5IF� GPMMPXJOH� �� RVFTUJPOT� DPODFSO� UIF� BNPVOU� PG� QBJO� ZPV� BSF� DVSSFOUMZ�
FYQFSJFODJOH�JO�UIF�IJQ�UIBU�ZPV�BSF�IBWJOH�FWBMVBUFE�UPEBZ��'PS�FBDI�TJUVBUJPO �QMFBTF�DJSDMF�
UIF�SFTQPOTF�UIBU�NPTU�BDDVSBUFMZ�SFGMFDUT�UIF�BNPVOU�PG�QBJO�FYQFSJFODFE�JO�UIF�QBTU����IPVST��
1MFBTF�DJSDMF�POF�BOTXFS�UIBU�CFTU�EFTDSJCFT�ZPVS�TJUVBUJPO��
26&45*0/��)PX�NVDI�QBJO�EP�ZPV�IBWF�� � �

�� 8BMLJOH�PO�B�GMBU�TVSGBDF �
��OPOF�
��NJME�
��NPEFSBUF�
��TFWFSF�
��FYUSFNF�
�� (PJOH�VQ�PS�EPXO�TUBJST �
��OPOF� � � � �
��NJME����
��NPEFSBUF���
��TFWFSF���������
��FYUSFNF�������
�� "U�OJHIU�XIJMF�JO�CFE �
��OPOF�
��NJME�
��NPEFSBUF�
��TFWFSF�
��FYUSFNF�
�� 4JUUJOH�PS�MZJOH �
��OPOF�
��NJME�
��NPEFSBUF�
��TFWFSF�
��FYUSFNF�
�� 4UBOEJOH�VQSJHIU �
��OPOF�
��NJME�
��NPEFSBUF�
��TFWFSF�
��FYUSFNF�

*/4536$5*0/4�� 5IF� GPMMPXJOH� �� RVFTUJPOT� DPODFSO� UIF� TZNQUPNT� UIBU� ZPV� BSF� DVSSFOUMZ�
FYQFSJFODJOH�JO�UIF�IJQ�UIBU�ZPV�BSF�IBWJOH�FWBMVBUFE�UPEBZ��'PS�FBDI�TJUVBUJPO �QMFBTF�DJSDMF�
UIF�SFTQPOTF�UIBU�NPTU�BDDVSBUFMZ�SFGMFDUT�UIF�TZNQUPNT�FYQFSJFODFE�JO�UIF�QBTU����IPVST��
1MFBTF�DJSDMF�POF�BOTXFS�UIBU�CFTU�EFTDSJCFT�ZPVS�TJUVBUJPO��
�26&45*0/��)PX�NVDI�USPVCMF�EP�ZPV�IBWF�XJUI��

�� $BUDIJOH�PS�MPDLJOH�PG�ZPVS�IJQ � � � � � � � � � � � � � � �
��OPOF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��NJME� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��NPEFSBUF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �

��TFWFSF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��FYUSFNF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
�� :PVS�IJQ�HJWJOH�PVU�PO�ZPV � � � � � � � � � � � � � � � � � � �
��OPOF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��NJME� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��NPEFSBUF� � � � � � � � � � � � �������������������������
��TFWFSF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��FYUSFNF�
�� 4UJGGOFTT�JO�ZPVS�IJQ �
��OPOF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��NJME� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��NPEFSBUF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��TFWFSF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��FYUSFNF�
�� %FDSFBTF�NPUJPO�JO�ZPVS�IJQ �
��OPOF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��NJME� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��NPEFSBUF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��TFWFSF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��FYUSFNF�

*/4536$5*0/4��5IF� GPMMPXJOH���RVFTUJPOT� DPODFSO�ZPVS�QIZTJDBM� GVODUJPO�� 'PS�FBDI�PG� UIF�
GPMMPXJOH�BDUJWJUJFT �QMFBTF�DJSDMF�UIF�SFTQPOTF�UIBU�NPTU�BDDVSBUFMZ�SFGMFDUT�UIF�EJGGJDVMUZ�UIBU�
ZPV�IBWF�FYQFSJFODFE�JO�UIF�QBTU����IPVST�CFDBVTF�PG�ZPVS�IJQ�QBJO��1MFBTF�DJSDMF�
26&45*0/��8IBU�EFHSFF�PG�EJGGJDVMUZ�EP�ZPV�IBWF�XJUI��

�� %FTDFOEJOH�TUBJST � � � � � � � � � � � � � � � � � � � � � � � � ���
��OPOF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��NJME� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��NPEFSBUF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��TFWFSF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��FYUSFNF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
�� "TDFOEJOH�TUBJST � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��OPOF� � � � � � � � � � � � � � � � � � � � �������������������
��NJME� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��NPEFSBUF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��TFWFSF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��FYUSFNF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
�� 3JTJOH�GSPN�TJUUJOH �
��OPOF�
��NJME�
��NPEFSBUF�
��TFWFSF�
��FYUSFNF�
�� 1VUUJOH�PO�TPDLT�TUPDLJOHT�
��OPOF�
��NJME�
��NPEFSBUF�
��TFWFSF�
��FYUSFNF�
�� 3JTJOH�GSPN�CFE �

��OPOF�
��NJME�
��NPEFSBUF�
��TFWFSF�
��FYUSFNF�

*/4536$5*0/4��5IF�GPMMPXJOH���RVFTUJPOT�DPODFSO�ZPVS�BCJMJUZ�UP�QBSUJDJQBUF�JO�DFSUBJO�UZQFT�PG�
BDUJWJUJFT��'PS�FBDI�PG�UIF�GPMMPXJOH�BDUJWJUJFT �QMFBTF�DJSDMF�UIF�SFTQPOTF�UIBU�PG�ZPVS�IJQ�QBJO �*G�
ZPV�EP�OPU�QBSUJDJQBUF�JO�B�DFSUBJO�UZQF�PG�BDUJWJUZ �QMFBTF�FTUJNBUF�IPX�NVDI�USPVCMF�ZPVS� IJQ�
XPVME�DBVTF�ZPV�JG�ZPV�IBE�UP�QFSGPSN�UIBU�UZQF�PG�BDUJWJUZ��1MFBTF�DJSDMF�POF�BOTXFS�UIBU�CFTU�
EFTDSJCFT�ZPVS�TJUVBUJPO��
�26&45*0/��)PX�NVDI�USPVCMF�EPFT�ZPVS�IJQ�DBVTF�ZPV�XIFO�ZPV�QBSUJDJQBUF�JO��

�� )JHI�EFNBOE�TQPSUT� JOWPMWJOH�TQSJOUJOH�PS�DVUUJOH� GPS�FYBNQMF � GPPUCBMM �CBTLFUCBMM � UFOOJT �BOE�
FYFSDJTF�BFSPCJDT
� � � � � � � � � � � � � ������
��OPOF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��NJME� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��NPEFSBUF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��TFWFSF�
��FYUSFNF�
�� -PX�EFNBOE�TQPSUT� GPS�FYBNQMF HPMGJOH�BOE�CPXMJOH
� � � � � � � � � � � � � � �
��OPOF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��NJME� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��NPEFSBUF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��TFWFSF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��FYUSFNF�
�� +PHHJOH�GPS�FYFSDJTF �
��OPOF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��NJME� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��NPEFSBUF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��TFWFSF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��FYUSFNF�
�� 8BMLJOH�GPS�FYFSDJTF � �
��OPOF�����������������������������������������
��NJME� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��NPEFSBUF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��TFWFSF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��FYUSFNF�
�� )FBWZ�IPVTFIPME�EVUJFT GPS�FYBNQMF MJGUJOH�GJSFXPPE�BOE�NPWJOH�GVSOJUVSF
� � � � � � � � � � � � � � � � � �
�����OPOF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
�����NJME� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
�����NPEFSBUF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��� ��TFWFSF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
�����FYUSFNF���
�� -JHIU�IPVTFIPME�EVUJFT GPS�FYBNQMF DPPLJOH �EVTUJOH WBDVVNJOH �BOE�EPJOH�MBVOESZ

��OPOF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��NJME� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��NPEFSBUF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��TFWFSF� � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � � �
��FYUSFNF�


*/4536$5*0/4��1MFBTF�BEE�UIF�OVNCFST�BTTPDJBUFE�XJUI�FBDI�PG�ZPVS����BOTXFST�UP�BSSJWF�BU�
UIF�SBX�TDPSF �.VMUJQIZ� � UIF�SBX�TDPSF�CZ������UP�PCUBJO�ZPVS�IJQ�TDPSF��

$ISJTUJBO�1�$ISJTUFOTFO .%�FU�BM �$033������