Hip

Question 1

Special Tests: Hip flexion contracture

Answer 1

Thomas test

Question 2

Special Tests: Glute Medius Weakness

Answer 2

Trendelenburg sign

Question 3

Special Tests: Femoroacetabular impingement

Answer 3

FADER

Question 4

Special Tests: Labral Lesion

Answer 4

Fitzgerald Test

• Anterior: Flex + ABduct + EROT → Extend + ADduct + IROT
• Posterior: Flex + ADduct + IROT → Extend + ABduct + EROT

Scour test

Question 5

Special Tests: Osteitis pubis

Answer 5

Hop test

Question 6

Special Tests: Stress fracture

Answer 6

• Fulcrum Test: Pt seated → Place hand under thigh → Downward force on knee w/ other hand
• Patellar Pubic Percussion: Stethoscope over pubis → Tap each patella

Question 7

Referred pain to hip

Answer 7

• Low back
• Knee
• Aorto-iliac vascular disease

Question 8

Special Tests: Thomas Test

Answer 8

Hip flexion contracture/tightness

• Pt brings both knees to chest then lowers one.
• (+) if pt unable to lower leg to table AND/OR arches thoracic spine when lowering leg

Question 9

Internal snapping hip syndrome

Answer 9

subluxation of iliopsoas over bony prominence

Question 10

Special Tests: Trendelenberg sign

Answer 10

Pelvis on side of elevated leg drops, indicates contralateral gluteus medius weakness

Question 11

Special Tests: IT Band tightness

Answer 11

Ober Test:

Question 12

Special Tests: Intra-Articular Hip

Answer 12

• FABER/Patrick
• Resisted straight leg raise
• Log Roll

Question 13

Measurement for leg length discrepancy

Answer 13

ASIS to Medial Malleoli: Significant if at least 2-3 cm

Question 14

Signs/symptoms OA

Answer 14

• Groin pain w/ wt bearing, relieved w/ rest
• Decreased passive IROT
• Lurch or Trendelenburg gait
• (+) Provocative Tests: FABER, log roll, resisted SLR

Question 15

Abutment of femoral had against the acetabulum due to osseous abnormality

Answer 15

Femeroacetabular impingment

Question 16

• Insidious onset of groin pain
• Worse w/ hip flexion
• Mechanical clicking/locking
• Pain w/ FADER

Answer 16

Femoroacetabular impingement

Question 17

Types of FAI

Answer 17

1. CAM: Young athlete-abnormal femoral head OR decreased head to neck ratio
2. Pincer: Middle aged women-abnormal/extended acetabulum, femoral retroversion, protrusio acetabuli
3. Mixed

Question 18

Complications of FAI

Answer 18

Early arthritis

Labral tears

Question 19

FAI: Imaging

Answer 19

• XR: AP Pelvis + Cross table lateral view
• CT Scan:
• MR Arthrogram: Good for demonstration on labral tear
• Alpha Angle: >50-55 degrees consistent w/ CAM impingement
  
  • Calculated form XR/CT/MRI

Question 20

Labral Lesion: Imaging

Answer 20

MR arthrogram

Question 21

Muscles Strains: Most common muscles

Answer 21

Hamstring: Pain w/ resisted knee flexion

Adductor: pain w/ resited adduction

NEED TO RULE OUT AVULSION

Question 22

Avulsion Fractures: Most commmon sites

Answer 22

• Sartorius from ASIS: Forceful contraction w/ hip extended and knee flexed
• Hamstring from Ischial Tuberosity
• Rectus Femoris from AIIS
• Adductor from pubic ramus
• Iliopsoas from lesser trochanter
• Abdominal muscle from iliac crest

Question 23

Internal snapping hip

Answer 23

Iliopsoas tendon over pectineal eminence of pelvis OR lesser trochanter

• Pain w/ resisted hip flexion
• (+) Thomas test

Question 24

External snapping hip

Answer 24

IT band subluxation over greater trochanter

• (+) Ober test
• (+) Tenderness over greater trochanter

Question 25

Inflammation on pubic symphysis

Answer 25

Osteitis pubus

Question 26

* Pain in groin or pubis symphysis * Popping sensation w/ ambulation * Weakness w/ resisted adduction * (+) Hop test * Tenderness to palpation over pubic symphysis

Answer 26

Osteitis pubis

Question 27

Types of femoral neck stress fractures

Answer 27

* **_Compression Type:_** Inferior aspect of femoral neck * **_Tension Type:_** Superior aspect of femoral neck

Question 28

**Treatment:** Compression type femoral neck stress fracture

Answer 28

Conservative