03 Hip 4 (Labral Tear and Other Tests) Flashcards Preview

7232 Ortho > 03 Hip 4 (Labral Tear and Other Tests) > Flashcards

Flashcards in 03 Hip 4 (Labral Tear and Other Tests) Deck (59):
1

What are the labral tear tests?

- static FADIR
- anterior labral tear test (FADIR)
- thomas test
- posterior labral tear test

2

For the labral tear tests, what are you testing for?

- labral tears
- FAI

3

labral tear tests: MOI

- repetitive stress
- macrotraumatic injury

4

labral tear tests: indications

pain and/or clicking over the hip

- deep pain for labral tear
- FAI is more sharp and pinching

5

labral tear tests: Which ones test for anterior labral tear or FAI?

- static FADIR
- anterior labral tear test (FADIR)
- thomas test

6

How many times do you perform the labral tear tests?

3x - none of them are resistance

7

static FADIR test positioning

- stand on side you're testing
- put the patient in flexion, adduction, and IR

8

anterior labral tear test: start and end position

start: flexion, abduction, ER

end: adduction, IR, extension

9

hand positions for the dynamic FADIR test

- one hand on ankle (fingers inside)
- other outside the knee

10

Which is the best test for an anterior labral tear or FAI?

Thomas test

11

What does the Thomas test do with respect to the labrum?

leg that's down is scraping the femoral head against the acetabulum on the anterior surface

12

posterior labral tear test: Is there a static version?

nope

13

posterior labral tear tests: start and end position

start: flexion, adduction, IR

end: abduction, ER, extension

14

Where are your hands in the posterior labral tear test?

opposite the anterior test (inside the knee)

15

Trendelenburg test: indications

- altered gait
- decreased hip abductor MMT

16

Trendelenburg test: procedure

- have them stand on one leg
- see if iliac crest stays level

17

Trendelenburg test: What makes it positive?

- contralateral hip drops
- pelvis doesn't stay level

18

Trendelenburg test: implications

weak hip abductors

19

Patrick's test aka

FABER

20

FABER test indications

differentiate between lumbar, hip, and SI pathology

21

FABER test: pain in groin

hip pathology

22

FABER test: posterior buttock pain

SI

23

FABER test: lateral pain

capsular tightness

24

FABER test: procedure

- figure 4 position
- add pressure on opposite ASIS to stabilize
- press on knee and assess response

25

FABER test: What makes it a positive test?

- reproduction of pain and/or
- loss of motion compared to opposite side

26

FAIR test is for this muscle

piriformis

27

indications for the FAIR test

possible piriformis syndrome

28

Where does the piriformis change function?

above 90˚ flexion

29

What does the piriformis do above 90˚?

IR

30

What does the piriformis do below 90˚?

ER

31

What makes a positive FAIR test?

reproduction of pain over intersection of piriformis and sciatic nerve

32

implications of the FAIR test

tight and/or irritated piriformis that may be contributing to sciatic symptoms

33

What is the FAIR test similar to?

FADIR - just in a different position

34

Which position would you use in the FAIR test for IR?

figure 4

35

Which position would you use in the FAIR test for ER?

- sidelying
- hook foot under other leg
- stabilize ASIS and hip
- downward pressure on knee

36

What does downward pressure (sidelying) do in the FAIR test?

- pushes into adduction and IR
- stretches the piriformis
if tight, it will reproduce symptoms

37

fulcrum test indication

possible stress fracture

38

What types of fractures of the LE are some of the most common in the body?

femoral neck and tibial stress fractures

39

What are some of the s/s of a femoral neck stress fracture?

- deep, throbbing groin pain
- much worse with weight bearing

40

How do you treat a femoral neck stress fx?

- unloading the hip (i.e. crutches)
- activity modification

41

What is the gold standard for detecting a femoral neck stress fracture?

bone scan, then MRI

42

What is the test for a femoral stress fx?

fulcrum test

43

What is a positive fulcrum test?

reproduction of sharp pain

44

female triad

- osteoporosis
- disordered eating
- amenorrhea

45

What are the implications of the female triad?

3 factors that increase the likelihood of femoral stress fractures

46

What is the Craig test used for?

to assess degrees of femoral anteversion or retroversion

47

Why might the Craig test be a poor choice? What is a better choice?

- no sensitivity or specificity
- 60˚ IR is a better measure
- can just use this as a corroborative test for regular gonio measurements

48

Craig test position

- prone, knee flexed to 90˚
- passively ER/IR until you feel the greater trochanter "disappear"
- have the patient hold and measure the angle

49

What is happening when the greater trochanter "disappears" in the Craig test?

femoral neck is parallel to the table

50

positive Craig test

If the angle is more than 8-15˚ in IR direction, indicates anteversion

51

implications of the Craig test

determines angle of femoral anteversion

52

Quadrant (SCOUR) indications

testing the inner/outer quadrants of the joint surface

53

quadrant (SCOUR) test position

- supine
- knee bent
- downward pressure
- 3 CW/3 CCW rotations

54

positive quadrant (SCOUR) test

- restriction felt in arc of motion
- pain is reproduced

55

implications of the quadrant (SCOUR) test

- capsular tightness
- adhesion
- myofascial restriction
- loss of joint congruity

56

indications for log roll test

anterior hip pain

57

procedure for log roll test

- supine
- passively IR/ER 3x

58

positive log roll test

movement reproduces symptoms

59

log roll test implications

intra-articular hip pathology