mcq on: Femoral  rotation  is  best  assessed  with  the  child 
recumbent,  either  supine  or  prone,  and  the  hips  in 
extension.  With  the  patient  supine,  the  physician 
rotates  the  entire  limb.  The  position  of  the  legs  is 
observed  in  both  internal  rotation  and  external  rotation.  Marked  internal  rotation  and  limited  external 
rotation of the femur strongly suggest internal femoral 
torsion.
Alternatively,  with  the  patient  prone,  the  pelvis  is 
maintained level and the knees are flexed. Medial rotation  refers  to  the  angle  between  vertical  and  the  axis 
of the tibia when the hips are maximally rotated inward. 
The internal hip rotation is accomplished by allowing 
the legs to fall outward by gravity alone. External rotation  is  also  measured,  with  the  patient  in  the  same 
position, by allowing the legs to cross. The pelvis needs 
to remain flat on the table.
Although it may be tempting to do this type of examination  with  the  patient  sitting,  the  patient  must  be 
examined with the hips in extension, because this position tightens the anterior joint capsule. When the hips 
are flexed, these ligaments are relaxed, thus permitting 
a greater range of external rotation and resulting in an 
inaccurate evaluation.