disorders of the hip

Question 1

hip joint pain causes

Answer 1

osteoarthritis, osteonecrosis, inflammatory conditions (RA, SA), fractures of femur or pelvis, dislocation

Question 2

hip joint pain location

Answer 2

groin, anterior proximal thigh, buttock, lateral thigh

Question 3

s/s of hip joint

Answer 3

decreased ROM, limp, inability to bear weight, inability to perform straight leg raise

Question 4

soft tissue pain around hip on lateral aspect of proximal thigh can be ..

Answer 4

trochanteric bursitis, lateral cutaneous nerve impingement, snapping hip syndrome

Question 5

pelvic differences between females and males

Answer 5

female pelvic is more oval or round, smaller compared to male

Question 6

other causes of hip and groin pain

Answer 6

SI joint pain, malignancy, infections, hernias, GI disorder

Question 7

hip dislocation etiology

Answer 7

when femoral head is displaced from acetabulum
high energy trauma

Question 8

hip dislocation presentation

Answer 8

severe pain, unable to move lower extremity

Question 9

hip dislocation PE

Answer 9

posterior dislocation - shortened affected limb, hip fixed in flexion, adduction and internal rotation, sciatic nerve palsy
anterior - hips fixed in mild flexion, abduction and external rotation

Question 10

hip dislocation secondary survey

Answer 10

femur or acetabulum fracture
abrasions
knee ligament injury

Question 11

hip dislocation imaging

Answer 11

AP of pelvis, AP and lateral views of the femur including knee

Question 12

hip dislocation treatment

Answer 12

reduction ASAP

Question 13

hip dislocation adverse outcome

Answer 13

avascular necrosis

Question 14

fracture of the femoral shaft etiology

Answer 14

usually caused by high energy trauma

Question 15

fracture of the femoral shaft presentation

Answer 15

severe pain in the thigh, deformity, unable to move or bear weight

Question 16

fracture of the femoral shaft imaging

Answer 16

AP and lateral of femur (looking for femur fx)
hip, knee, and pelvis xray

Question 17

fracture of the femoral shaft treatment

Answer 17

traction, surgery

Question 18

fracture of the femoral shaft adverse outcomes

Answer 18

fat embolism, multisystem organ failure, complications of open fractures

Question 19

traumatic fracture of the pelvis etiology

Answer 19

fx of pelvic ring or acetabulum
always two fracturs

Question 20

traumatic fracture of the pelvis presentation

Answer 20

may be associated with massive blood loss
signs of hypovolemic shock
groin pain, lateral hip or buttock area

Question 21

traumatic fracture of the pelvis PE

Answer 21

push on ASIS with patient supine

Question 22

traumatic fracture of the pelvis treatment

Answer 22

surgery

Question 23

pelvic fracture treatment

Answer 23

can be treated non-surgically

Question 24

fracture of the proximal femur

Answer 24

common in elderly individuals
generally involve femoral neck, intertrochanteric region

Question 25

femur fracture risk factors

Answer 25

advanced age, smoking, white women, dizziness, alcoholism, osteoporosis

Question 26

femur fracture presentation

Answer 26

history of fall, pain in groin, inability to bear weight. thigh pain, knee pain!!

Question 27

femur fracture PE

Answer 27

externally rotated, abducted limb shortened if displaced pain with log roll test unable to straight leg raise

Question 28

femur fracture imaging

Answer 28

AP of pelvis, cross table lateral view of hip. avoid frog lateral d/t pain

Question 29

femur fracture treatment

Answer 29

ortho referral, surgery within 48 hrs d/t high risk for thromboembolic events, evaluate for osteopororis

Question 30

osteonecrosis

Answer 30

death of varying amounts of bone in femoral head steroids? (prednisone)

Question 31

stages of osteonecrosis

Answer 31

cellular, fragment collapse, surface collapse, arthritis development

Question 32

osteonecrosis presentation

Answer 32

dull ache or throbbing pain in groin/thigh, hip or buttock limited ROM, progressive limp

Question 33

osteonecrosis PE

Answer 33

pain with attempted straight leg raise and ROM of hip

Question 34

osteonecrosis imaging

Answer 34

AP of pelvis, frog lateral view, MRI if needed

Question 35

osteonecrosis ddx

Answer 35

fracture of femoral neck, lumbar disc disease, muscle sprain, osteoarthritis, SA

Question 36

osteonecrosis treatment

Answer 36

surgical intervention

Question 37

hip impingement aka femoral acetabular impingement etiology

Answer 37

occurs when ossesous deformities occur on acetabular rim, femoral head-neck junction or both

Question 38

femoral acetabular impingement presentation

Answer 38

C sign worse with prolonged sitting, stairs, getting into/out of car pain over greater trochanter

Question 39

femoral acetabular impingement PE

Answer 39

pain and limited internal rotation decreased hip flexion and internal rotation positive impingement sign

Question 40

femoral acetabular impingement treatment

Answer 40

acetaminophen, NSAIDs, activity modification, deep tissue massage for refractory cases - surgery

Question 41

lateral femoral cutaneous nerve syndrome (meralgia paresthetica) etiology

Answer 41

compression or entrapment of the lateral femoral cutaneous nerve tight clothing/belt, trauma, obesity

Question 42

lateral femoral cutaneous nerve syndrome presentation

Answer 42

pain, burning, hypoesthesia

Question 43

lateral femoral cutaneous nerve syndrome treatment

Answer 43

remove cause, pain medication if needed

Question 44

snapping hip etiology

Answer 44

snapping or popping sensation due to tendons around the hip moving over bony prominences IT band snapping over greater trochanter most common

Question 45

snapping hip presentation

Answer 45

iliotibial - occurs with walking or rotation of hip. localized to trochanteric area iliopsoas - felt in groin as hip extends (rising from chair)

Question 46

snapping hip treatment

Answer 46

reassurance, avoid proactive maneuvers, exercise to stretch if pain - NSAIDs

Question 47

hip and thigh strains etiology

Answer 47

injuries to the muscle-tendon units around the joints

Question 48

hip and thigh strains presentation

Answer 48

pain over injured muscles that is exacerbated when they are continuously used

Question 49

stress fractures of the femoral neck (hip) etiology

Answer 49

result from dynamic, continuing process occurs most commonly in athletes, advanced age, military

Question 50

stress fractures of the femoral neck presentation

Answer 50

groin and thigh pain associated with weight bearing usually subsides after cessation of activity pain with extreme ROM of hip

Question 51

stress fractures of the femoral neck imaging

Answer 51

may be missed on plain imaging bone scans can detect stress factors maybe MRI

Question 52

stress fractures of the femoral neck treatment

Answer 52

cessation of activity non-weight bearing surgical emergency if young patient

Question 53

trochanteric bursitis etiology

Answer 53

lateral hip pain. inflammation and hypertrophy of greater trochanteric bursa

Question 54

trochanteric bursitis presentation

Answer 54

pain and tenderness over the greater trochanter area may radiate to knee or ankle or buttock worse when first rising from sitting unable to lie on affected side

Question 55

trochanteric bursitis treatment

Answer 55

injection of local anesthetic and corticosteroids, NSAIDs, activity mod, IT band stretching, cane usage