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Musculoskeletal Pathophysiology > Hip > Flashcards

Hip Flashcards

1
Q

What is congenital hip dysplasia, and its cause?

A

Sublux due to breech delivery

-abnormal lax hip capsule

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2
Q

CHD usually results in a muscle contracture of which group?

A

Adductors (short)

-2* hip drop from dysplasia

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3
Q

What two maneuvers can be used to test for CDH?

A

Barlow maneurver

  • dislocation
  • adduction

Ortolani Test

  • relocation
  • abduction
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4
Q

What position should the hip be in to correct CDH and what is the brace called?

A

fxn, abd

Pavlik Harness

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5
Q

What is Legg-Calve-Perthes Disease? What is its pathophysiology?

A

Osteonecrosis of femoral head.
-idiopathic

5M:1F
15% B

Arteries occluded, subchondral bone dies

  • revascularized over time
  • subchondral bone can fx without protection
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6
Q

What does LCPD look like on imaging? What are some early signs?

A

Can present as crescent sign of subchondral collapse.

Antalgic gait, hip pain
adductor spasm

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7
Q

What are the stages of LCPD?

A
  1. Necrosis
  2. Fragmentation
    - reabsorb bone
  3. Re-ossification
    - new bone
  4. Remodeling
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8
Q

In what orientation should a leg with LCPD be braced?

A

IR and ABD

Scottish Rite orthosis

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9
Q

What Salter-Harris grade is a Slipped Capital Femoral Epiphysis (SCFE)? What direction does it move?

A

grade 1 epiphyseal slip

  • sublux posterior-inferior
  • Flattened femoral head
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10
Q

Who is most affected by SCFE?

A

2.5M:1F
10-16 yo
-short/fat
-tall/thin

Gradual onset
-quad atrophy

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11
Q

How do you grade SCFE?

A

By how much the femoral head has slipped off the neck

  1. 50%
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12
Q

Chronic SCFE injuries are most common. How long until one can resume regular activities?

A

3-6 months.

-NWB first 6 weeks

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13
Q

Septic hip is a rapidly progressing joint infection with considerable effusion and is very hot in <2 yo. What orientation is the hip in?

A

FABER
Flexion
Abduction
ER

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14
Q

What are a few chronic avulsion fracture sites in youth?

A

AIIS
ASIS
Greater troch
Lesser troch

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15
Q

Hip OA usually limits motion in a capsular pattern. Which surfaces of the hip are usually destroyed in OA?

A

FEMORAL HEAD
Posterior
Superior

ACETABULUM

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16
Q

What is the capsular pattern of the hip?

A

IR > FXN > ABD

17
Q

What types of surgery are available for hip OA?

A 
Arthroplasty
Osteotomy (usually varus)
-wedge from medial femoral shaft to change weight bearing surface

Arthrodesis (fusion)

18
Q

Anterolateral approach to THR dissects the gluteus medius. What is the restrictions?

A

Limit extension, ADD, ER

19
Q

A trans-trocahnteric approach osteomizes the greater troch. What are it’s restrictions?

A

Ext/add/IR

20
Q

What are some complications post THR?

A

Infection
DVT
Dislocaiton
Loosening of cement

21
Q

In what position is a hip usually fused for arthrodesis?

A

Neutral ABD
ER = 0-30
FXN = 20-25

Orientation minimizes lumbar motion.

22
Q

What typically causes osteonecrosis?

A

Subchondral bone death.

23
Q

Which artery supplies the femoral head?

A

Medial circumflex.

24
Q

What is the crescent sign of AVN?

A

1st area of hyperluscency in fem head around articular surface. Bone later dies and collapses down.

25
Q

Why is it important to catch AVN early?

A

It can revascularize with change in WB.

26
Q

A posterior hip dislocation is most commonly associate with what trauma?

A

Acetabluar fracture.

-femur is ADD/IR on impact

27
Q

What’s the difference between a capital fx and femoral neck fx?

A

Both are intercapsular

Captial = head

  • 2* to osteoporosis
  • shortened LE
28
Q

Is an intertrochanteric fx intercapsular?

A

No, extracapsular

  • <1% AVN
  • most are comminuted
29
Q

What are some signs of an acetabular tear?

A
  • Pain with fxn

- Catching, clicking or locking

30
Q

Where is the iliopectineal bursa?

A

Between psoas and anterior hip joint.

Musculoskeletal Pathophysiology (9 decks)

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