Hip

Question 1

Hip issue related to age: 0-2

Answer 1

develipmental dysplasia

septic arthritis

Question 2

Hip issue related to age: 2-12

Answer 2

Acute transient synovitis

legg-calve-perthes

Question 3

Hip issue related to age: 8-17

Answer 3

Slipped capital femoral epiphysis

Question 4

Hip issue related to age: 5-30

Answer 4

Osteoid Osteoma (femoral neck)

Question 5

Hip issue related to age: 40-50

Answer 5

Idiopathic Avascular Necrosis

Question 6

Hip issue related to age: >35

Answer 6

RA

Question 7

Hip issue related to age: >40

Answer 7

Degenerative Joint Disease

Question 8

Hip issue related to age: >50

Answer 8

Hip fracture

Question 9

Normal anteversion

Answer 9

8-15deg

Question 10

Anteverted hip

Answer 10

torsion >15deg (toe in, excessive IR ROM)

Question 11

Retroverted Hip

Answer 11

Torsion <8deg (toe out, excessive ER and limited IR ROM)

Question 12

Transient Synovitis Symptoms

Answer 12

2-10yo
limp, refusal to walk
Fever <101
Decreased IR ROM

Question 13

Legg-Calve-Perthes

Answer 13

9-12yo male
Unilateral
Necrosis of femoral neck
Self limiting
Pain at night

Question 14

SCFE

Answer 14

most common hip disorder in adolescents
9-17yo male, obese, african american
Growth plate not fused yet
Gradual symptoms

Question 15

How to rule out intra-articular pathology

Answer 15

FABER test

Question 16

Obturator Nerve Entrapment

Answer 16

Activity/exercise induced
Medial thigh pain with exercise, improves with rest
Adductor weakness WITHOUT pain
EMG diagnostic

Question 17

Labral tear vs OA

Answer 17

Labrum = pain at groin, peritrochanteric, ant thigh, ischial
OA = ant thigh or ischial

Question 18

Osteonecrosis of Femoral Head (ONFH) risk factors

Answer 18

prior trauma
long term alcohol use
long term corticosteroid use
connective tissue disease (lupus)

Question 19

Hip OA CPG: diagnosis criteria

Answer 19

A level
Mod ant/lat hip pain with WB
Morning stiffness <1hr
Hip IR <24deg
Hip IR and flex 15 less vs opposite side
Increased pain with passive IR

Question 20

Hip OA CPG: Outcome measures - pain

Answer 20

A level
WOMAC - pain
BPI
PPT
VAS

Question 21

Hip OA CPG: outcome measures - activity limitation and participation restriction

Answer 21

A level
WOMAC physical function
HOOS
LEFS
HHS

Question 22

Hip OA CPG: Exam - Activity limitation/physical performance measures

Answer 22

A level
6min walk test
30 sec chair stand
Stair measure
TUG
Self paced walk
Timed single leg stance
4 square step test
Step test

Question 23

Hip OA CPG: Exam - Activity limitation/physical performance measures for balance

Answer 23

A level
Berg balance scale
4 square step test
timed single leg stance test

Question 24

Hip OA CPG: Exam - Physical Impairment measures

Answer 24

A level
FABER test
PROM: IR, ER, flex, ext, abd, add
MMT: IR, ER, flex, ext, abd, add

Question 25

Hip OA CPG: Interventions - Pt ed

Answer 25

``` B level Pt ed + exercise and/or manual Activity modification Exercise for weight reduction Unloading joint ```

Question 26

Hip OA CPG: Interventions - Functional, gait, and balance training

Answer 26

C level Impairment based training Individualized program AD training

Question 27

Hip OA CPG: Interventions - Manual therapy

Answer 27

A level | 1-3x/wk for 6-12wks

Question 28

Hip OA CPG: Interventions - flexibility, strength, endurance

Answer 28

A level | Individualized programs

Question 29

Hip OA CPG: Interventions - Modalities

Answer 29

B level | US (1MHz; 1w/cm2 for 5 min)

Question 30

Hip OA CPG: Interventions - Bracing

Answer 30

F level, don't use it

Question 31

Hip OA CPG: Interventions - weight loss

Answer 31

C level | Collaborate with other providers

Question 32

Nonarthritic Hip CPG: Risk factors

Answer 32

F level - presence of osseous abnormalities - local or global ligamentous laxity - connective tissue disorders - nature of pts activity and participation

Question 33

Nonarthritic Hip CPG: Diagnosis/classification - nonarthritic hip joint pain

Answer 33

C level - clinical findings of: - anterior groin or lateral hip pain, or generalized hip jt pain reproduced with FADIR or FABER - consistent imaging findings

Question 34

Nonarthritic Hip CPG: Exam: Outcome measures

Answer 34

A level - HOS - HAGOS - iHot-33

Question 35

Nonarthritic Hip CPG: Exam: physical impairment measures

Answer 35

B level - measures of hip pain - hip ROM - hip strength - movement coordination

Question 36

Nonarthritic Hip CPG: Intervention: pt ed and counseling

Answer 36

F level: modify aggravating factors

Question 37

Nonarthritic Hip CPG: Intervention: manual therapy

Answer 37

F level: jt mobs and STM when indicated

Question 38

Nonarthritic Hip CPG: Intervention: Therex and Therac

Answer 38

F level: can use therex and therac to address jt mobility, muscle flexibility, muscle strength, muscle power deficits, deconditioning, metabolic disorders

Question 39

Nonarthritic Hip CPG: Intervention: NMR

Answer 39

F level: use NMR to diminish movement coordination impairments

Question 40

Cam impingement

Answer 40

asphericity of femoral head, often related to SCFE

Question 41

Pincer impingement

Answer 41

acetabular abnormalities: | -excessive acetabular coverage anteriorly

Question 42

Combo Cam/Pincer impingement

Answer 42

likely most common presentation

Question 43

Acetabular labral tear mechanism

Answer 43

acute trauma (forceful rotation with hip in hyperextended position) or insidious onset

Question 44

Nonarthritic Hip CPG: Exam: balance

Answer 44

Berg balance scale 4-square step test timed single leg stance test