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MSK 2 (F22) > Hip Pathology > Flashcards

Hip Pathology Flashcards

1
Q

Piriformis Syndrome: population & risk factors

A

F > M
Prolonged sitting.
Sciatic N variant.
Lumbar/SIJ patho.

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2
Q

Piriformis Syndrome: MOI

A

Trauma to gluteal region.
Post-surgical injury.
Overuse.

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3
Q

Piriformis Syndrome: objective exam

A

Normal DTRs.
(+) FAIR
Piriformis TTP
Weak hip ABD & ext

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4
Q

Piriformis Syndrome: subjective exam

A

Gluteal pain (can refer to hip, thigh, lower leg).
Paresthesia along sciatic N.
Difficulty walking.
Aggs = prolonged sitting, squatting, stairs.

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5
Q

Piriformis Syndrome: old theory

A

Caused by shortened/tight piriformis

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6
Q

Piriformis Syndrome: new theory

A

Caused by lengthened piriformis; due to compensation for weak glutes. But piriformis much smaller than glutes, so it gets STRESSED

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7
Q

Piriformis Syndrome: how can we test for weak glutes/ piriformis compensation?

A

Squat or stairs. If knee goes into valgus, piriformis prob trying too hard

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8
Q

GTPS is a broad pathology, describing…

A

Lateral hip pain & tenderness near the greater trochanter

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9
Q

GTPS: MOI

A

Repeated microtrauma to glut tdn insertion on GT.
Repeated hip flex/ext = friction of ITB over GT.

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10
Q

GTPS: population/risk factors

A

Ipsi ITB pain
Knee OA
Obesity
40-60yo
F > M

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11
Q

GTPS: subjective

A

Pain in lateral hip/buttock with lying on painful side, prolonged standing/sitting, STS, cross leg sitting, stairs, running & high impact activity.
Flexion causes tension on ITB.

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12
Q

GTPS: objective

A

TTP near greater trochanter
Pain with: passive hip adduction, resisted ABD, resisted IR.
SL stance: cannot hold for 30s without ↑ pain and/or Trend.
(+) FABER - stretches glut med/min tdns
(+) External Derotation

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13
Q

GTPS: non-PT treatment

A

NSAID, rest, ice, weight loss, cortico inject, platelet rich plasma, shock wave therapy.
Surgery: glut tdn repair, ITB release, bursectomy

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14
Q

GTPS: pt education

A

Avoid running on cambered surfaces (beaches).
Avoid extreme hip adduction positions (cross-leg sitting).
Sleep on non-painful side.
Avoid stretching piriformis, ITB, adductors.
Avoid hanging on 1 hip in standing.

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15
Q

GTPS: PT treatment Phase 1

A

Activity modification, pain management.
Prolonged isometrics (helps pain).

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16
Q

GTPS: PT treatment Phase 2

A

Heavy, slow resistance exercise.
Prolonged isometrics.

17
Q

GTPS: PT treatment Phase 3

A

Sports-specific movements

18
Q

GTPS: PT treatment Phase 4

A

Return to sport

19
Q

Athletic Pubalgia: population/risks

A

Young athletes
M > F
70% soccer
Muscle imbalance

20
Q

Athletic Pubalgia: often affects what muscles?

A

Rectus abdominis
Adductor longus
Psoas

21
Q

Athletic Pubalgia: pathophysiology

A

Powerful muscles pull & stress bone.
Muscle imbalance alters ability to transmit load, leading to pelvic instability & damage to tdn/musc/bone.

22
Q

Athletic Pubalgia: subjective

A

Pain in lower abdominal, groin, inguinal region
Aggs = Valsalva, kicking, cutting, sprinting, resisted situps

23
Q

Athletic Pubalgia: MOI

A

Insidious onset. Twist, kick, turn, direction change

24
Q

Athletic Pubalgia: objective

A

ROM: decreased hip ABD, IR, ER.
Weak/painful hip adduction.
TTP: pubic tubercle, superior pubic ramus, pubic symph, lower abs, hip adductors.

25
Q

Athletic Pubalgia: interventions

A

Pain control
ROM, strength (goal is adductor:ABDuctor ratio >80%)
Lumbopelvic stability
Return to sport

26
Q

OA: 3 components

A

cartilage damage + narrow joint space + osteophytes.

27
Q

OA: gold standard for dx

A

xray

28
Q

OA: pt population/risks

A

> 50-55yo
Pediatric hip pathologies
Limb length discrepancy

29
Q

OA: with limb length discrepancy, which side is usually more susceptible to OA?

A

longer, bc swinging gait = increased pressure on lateral rim of hip

30
Q

OA: subjective

A

Unilateral hip pain, deep/ache, stiffness, crepitus.
Aggs = anything that shoves femoral head into acetabulum (squat, ascend stairs, active hip ext).
Pain with disuse, vigorous use, or after period of rest.

31
Q

OA: objective

A

Decreased P/AROM: d/t local inflammation.
Capsular patten: IR > flex > ABD > maybe ext
(+) FABER, FADIR, Scour

32
Q

OA: CPR 1 (at least 4/5)

A
  1. Agg = squat
  2. Lateral hip pain w/ flexion
  3. Lateral hip pain (or groin) with Scour Test adduction
  4. Pain w/ extension
  5. IR PROM < 25°
33
Q

OA: CPR 2a & 2b (must meet all 3 of either)

A

Option a:
1. Hip pain
2. IR AROM < 15°
3. Flexion AROM < 115°

Option b:
1. Morning stiffness <60min
2. IR < 25° with pain
3. Age >50yr

34
Q

OA: interventions

A

Educate on pain management.
Strengthen around the joint.
Flexibility of antagonist.

MSK 2 (F22) (17 decks)

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