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MSK Year 3 > Conditions of the Hip > Flashcards

Conditions of the Hip Flashcards

1
Q

Name the three bones that are fused to form the hip

A

Ileum
Ischium
Pubis

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2
Q

The three bones of the hip are fused by which 2 structures

A

Sacrum

Pubic symphysis

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3
Q

Which muscles attach to the greater trochanter of the femur?

A

Abductors

Rotators

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4
Q

What muscle attaches to the lesser trochanter of the femur?

A

Psoas

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5
Q

Blood supply to the hip joint

A

Medial and Lateral circumflex - branches of profunda femoris
Artery of ligamentum teres
Blood supply enters through capsule

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6
Q

Difference between effect on blood supply in intracapsular and extracapsular fracture of femur

A

Intracapsular- fracture of neck - blood supply disrupted

Extracapsular - blood supply maintained

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7
Q

2 changes in osteoarthritis

A

Progressive loss of articular cartilage

Secondary bone changes

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8
Q

What is osteoarthritis?

A

Degenerative change in synovial joints

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9
Q

Symptoms of osteoarthritis

A

Worsening pain

Stiffness

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10
Q

Causes of trochanteric bursitis

A 
Trauma
Over-use; athletes, runners, repetitive movement
Abnormal movements
- Distant
-Local
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11
Q

Which ‘distant’ problem can cause abnormal movement in the hip joint leading to trochanteric bursitis?

A

Scoliosis

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12
Q

Which local problems to the hip can cause abnormal movement that can lead to trochanteric bursitis?

A

Muscle wasting following surgery
Total hip replacement
Osteoarthritis

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13
Q

Presentation of trochanteric bursitis

A

Point to tenderness

Tenderness in lateral hip

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14
Q

Examination findings in trochanteric bursitis

A

Scars from previous surgery?
Muscle wasting (glutes)
Tenderness at greater tuberosity
Worst pain at active abduction

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15
Q

Investigations for trochanteric bursitis

A

X ray
MRI
Ultrasound

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16
Q

Treatment for trochanteric bursitis

A 
NSAIDs
Rest
Activity modification
Physio - posture, movements, strengthening and stretching
Injection - glucocorticosteroids
Surgery - bursectomy
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17
Q

What happens in avascular necrosis?

A

Loss of blood supply –> death of bone

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18
Q

What age is avascular necrosis more likely to be diagnosed>

A

35-50

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19
Q

Is avascular necrosis more common in males or females>

A

Males

20
Q

Risk factors for avascular necrosis fall under which 2 categories

A

Trauma

Systemics

21
Q

Traumatic causes of avascular necrosis

A

Irradiation
Fracture
Dislocation
Iatrogenic

22
Q

Systemic causes of avascular necrosis

A 
Idiopathic
Hypercoagulable states
Steroids
Haematological - sickle cell disease, leukaemia, lymphoma
Caisson's disease
Alcoholism
23
Q

What symptom is common is Caisson’s disease?

A

Decompression sickness

24
Q

What does decompression sickness occur with Caisson’s disease?

A

Nitrogen bubbles throughout body

25
Q

Symptoms of avascular necrosis

A

Insidious onset of groin pain
Pain with stairs, walking uphill, on impact
Limp

26
Q

Findings of avascular necrosis on examination

A

Can replicate OA - stiffness, reduced ROM

27
Q

Non-operative treatment of avascular necrosis

A 
Activity modification
NSAIDs
Bisphosphonates
Anticoagulants
Physio
28
Q

Operative treatment of avascular necrosis

A

Core decompression and vascularised graft : Blood supply
Rotational osteotomy: Move lesion from weight-bearing area
Total Hip Replacement

29
Q

Types of femoroacetabular impingement

A

Cam Lesion - femur based

Pincer - acetabulum based

30
Q

3 steps in formation of pincer impingement

A

Abnormal acetabulum

  • -> anterosuperior overhang
    • -> acetabular protrusion

–>abutement of lesion on edge of acetabulum

31
Q

Associated injury of pincer impingement

A

Labral degeneration and tears
Cartilage damage and flap tears
Secondary hip osteoarthritis

32
Q

Signs and symptoms of femoroacetabular impingement

A

Groin pain - worse with flexion
Mechanical symptoms
- block to movement
- pain; getting up, chair, squat, lunge

33
Q

Examination findings of impingement

A 
Reduced flexion and internal rotation
Positive FADIR test
-Flexion
Addcution
Internal Rotation
34
Q

A positive FADIR tests indicates which hip pathology?

A

Femoroacetabular impingement

35
Q

Investigations for femoroacetabular impingement - imaging

A

X-ray

MRI

36
Q

Non-operative treatment of FA impingement

A

Physio
NSAIDs
Activity modification

37
Q

Operative treatment of FA impingement

A

Arthroscopy - shave off impingement, deal with labral tears, resect cartilage flaps

Open surgery -Resection, Periacetabular osteotomy, Hip arthroplasty - resurfacing, replacement

38
Q

Most common type of labral tear

A

Anterosuperior

39
Q

Labral tears occur most commonly in active females as a result of what pathology

A

Pincer impingement - flexibility

40
Q

Causes of labral tears

A 
Femoroacetabular Impingement
Trauma
Dysplasia
Osteoarthritis
Collagen diseases - Ehler Danlos
41
Q

Symptoms of labral tear

A

Hip or groin pain
Snapping sensation
Jamming or locking

42
Q

Findings on examination

A

Positive FABER
Flexion
Abduction
External Rotation

43
Q

Investigation for labral tear

A

X ray
MRI
Diagnostic injection

44
Q

Non- operative treatment of labral tear

A

NSAIDs
Activity
Steroids
Physio

45
Q

Operative treatment of labral tear

A

Arthroscopy - resection and repair

46
Q

A positive FABER test indicated which hip pathology?

A

Labral tear

MSK Year 3 (8 decks)

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