Adult hip conditions

Question 1

What is FAI (femoroacetabular impingement syndrome)?

Question 2

What are the actions that usually cause impingement in FAI?

Answer 2

Flexion, adduction, internal rotation

Question 3

What are the types of FAI? Describe each.

Answer 3

1. CAM type impingement
2. Pincer type impingement
3. Mixed deformity

Question 4

How does FAI present and how to diagnose?

Question 5

How does a labrum tear look like on imaging?

Question 6

How to manage FAI?

Question 7

What is avascular necrosis and what is the pathophysiology?

Question 8

What are risk factors of AVN?

Question 9

How does AVN present and how to diagnose it?

Question 10

What are the stages of AVN and how to manage them?

Question 11

What is idiopathic transient osteonecrosis of the hip (ITOH)?

Question 12

How to diagnose ITOH?

Answer 12

Gold standard - MRI

Question 13

What is trochanteric bursitis?

Answer 13

Repetitive trauma caused by iliotibial band tracking over trochanteric bursa

Question 14

How does trochanteric bursitis present and how to diagnose? How is it managed?

Answer 14

Mx:
Analgesia
NSAIDs
Physiotherapy
Steroid injection
No proven benefit from surgery

Question 15

What are potential precipitants of SECONDARY osteoarthritis?

Question 16

Are the surgical treatments for OA and inflammatory conditions similar?

Answer 16

Yes

Question 17

What is OA and what are patient presentations for hip OA?

Answer 17

Presentation:
Pain at night *(an indicator for surgical management)

Question 18

How to assess hip OA and how to diagnose?

Answer 18

Dx:
Radiographs
- Joint space narrowing
- Subchondral sclerosis
- Osteophytes
- Cyst formation

Question 19

How to manage osteoarthritis?

Question 20

What are considerations for surgical planning in THR?

Answer 20

• Centre of rotation (high/low compared to line of greater trochanter)
• Leg length discrepancy
• Offset
• Canal width