Clincal Conditions Of The Hip

Question 1

Cause of primary osteoarthritis

Answer 1

Idiopathic
Cause unknown

Question 2

Risk factors of osteoarthritis

Answer 2

Age
Sex female >male
Ethnicity
Nutrition
Genetics- runs in family

Question 3

Causes of secondary osteoarthritis

Answer 3

Obsesity
Trauma
Malalignment
Infection
Inflammatory arthritis - RA
Metabolic disorders affecting joints
Haematological disorders
Endocrine abnormalities

Question 4

Symptoms of osteoarthritis in hip

Answer 4

Joint stiffness
Morning stiffness < 1 hour
Pain + tenderness
Crepitus
Reduced mobility
Trendelenburg sign
Pain reduced by rest

Question 5

How is osteoarthritis diagnosed

Answer 5

By clinical presentation
Supported by X rays - LOSS

Question 6

X ray changes of osteoarthritis

Answer 6

LOSS

Loss of joint spac
Osteophytes
Subarticular sclerosis
Subchondral cysts

Question 7

Management of osteoarthritis of hip

Answer 7

Activity modifications - if it hurts don’t do it
Weight loss
Physiotherapy
Medications - NSAIDs, COX-2 inhibitors
Injections - corticosteroids to reduce inflammation
Hip replacement surgery

Question 8

Types femur fracture

Answer 8

intracapsular fracture - NOF
extracapsular fracture - trochanteric + subtrochanteric

Question 9

Why does a intracapsular fracture of the femur have a high risk of avascular necrosis?

Answer 9

Damage to medial femoral circumflex artery

Question 10

Signs + symptoms of proximal femur fractures

Answer 10

Decreased mobility
Sudden inability to bear weight
Pain in hip, groin or knee
Short
Externally rotated
ABducted

Question 11

Causes of a vascular necrosis

Answer 11

Mechanical disruption - fracture
Excess alcohol
Excessive steroid use
Post-trauma
Thrombosis
Hypertension

Question 12

Management of extracapsular fracture of femur

Answer 12

Nails
Pin and plate

Question 13

Management of intracapsular fracture of femur

Answer 13

Replace femoral head

Question 14

What is the most common hip dislocation? Why?

Answer 14

Posterior
Only ischiofemoral ligament on posterior surface - weakest

Question 15

What does a posterior hip location present as?

Answer 15

• Shortened
• Internally rotated
• ADducted
• Flexed

iPDF - internal rotation | Posteior | ADducted | flexed

Question 16

What nerve can be damaged in posterior hip dislocation?

Answer 16

Sciatic nerve

Question 17

Complication of hip dislocations

Answer 17

Avascular necrosis
Post traumatic OA
Recurrent dislocation
Sciatic nerve injury
Infection
Superior gluteal nerve injury

Question 18

How does an anterior hip dislocation present?

Answer 18

Externally rotation
ABducted
Slightly flexed

Question 19

What type of dislocation is a central hip location always?

Answer 19

Fracture dislocation

Question 20

Where is the femoral head palpable in a central hip dislocation?

Answer 20

Femoral head palpable per rectum

Question 21

Presentation of neck of femur fracture vs a posterior hip dislocation

Answer 21

NOF fracture - shortened
- ABducted
- externally rotated

Dislocation - shortened
- ADducted
- internally rotated

Question 22

Mechanism of a pulled hamstring

Answer 22

Sudden muscular exertion - stretching of posterior thigh muscles

Question 23

Causes of hamstring injuries

Answer 23

Muscle sprain
Partial or complete tear of hamstrings from ischial tuberosity

Question 24

What can a complete tear of hamstring muscles of ischial tuberosity cause?

Answer 24

Avulsion fracture

Question 25

What muscles will be impacted by injury to superior gluteal nerve?
What does this cause?

Answer 25

Gluteus medius
Gluteus minimus

Weakness in ABducting hip&raquo_space; Trendelenburg’s sign

Question 26

Causes of superior gluteal nerve injury

Answer 26

• Hip surgery complication
• Buttock injection
• Greater trochanter fracture - insertion of gluteus medius
• Hip joint dislocation

Question 27

What type of nerve injury causes Trendelenburg’s sign?
Why?

Answer 27

Superior gluteal nerve injury
Supplies hip ABductors - gluteus medius + minimus&raquo_space; don’t contract to prevent tilting