Hip and Pelvis Soft Tissue Flashcards by Heather Stephens

If a patient reports of pain in the lateral thigh and is exacerbated when transferring from sitting to standing, what is your initial hypothesis?

a. OA
b. Labral Tear
c. Greater trochanteric bursitis or muscle strain
d. Avascular Necrosis

Greater trochanteric bursitis or muscle strain

How well did you know this?

Not at all

Perfectly

If a patient is >60 y/o and reports of pain and stiffness in the hip with possible radiation into the groin, what is your initial hypothesis?

a. OA
b. Labral Tear
c. Greater trochanteric bursitis or muscle strain
d. Avascular Necrosis

How well did you know this?

Not at all

Perfectly

A patient reports of clicking and/or catching in the hip joint. Pain exacerbated by full flexion or extension, what is your initial hypothesis?

a. OA
b. Labral Tear
c. Greater trochanteric bursitis or muscle strain
d. Avascular Necrosis

Labral tear

How well did you know this?

Not at all

Perfectly

Patient reports of a repetitive or overuse injury, what is your initial hypothesis?

a. Muscle sprain/strain
b. Labral Tear
c. Greater trochanteric bursitis or muscle strain
d. Avascular Necrosis

Muscle sprain/train

How well did you know this?

Not at all

Perfectly

Patient reports of deep, aching throb in the hip or groin and a possible history of prolonged steroid use, what is your initial hypothesis?

a. OA
b. Labral Tear
c. Greater trochanteric bursitis or muscle strain
d. Avascular Necrosis

Avascular necrosis

How well did you know this?

Not at all

Perfectly

Patient reports of pain in the gluteal region with occasional radiation into the posterior thigh and calf, what is your initial hypothesis?

a. Avascular Necrosis
b. Piriformis syndrome, hamstring strain or ischial bursitis
c. Greater trochanteric bursitis
d. Labral tear

Piriformis syndrome, hamstring strain or ischial bursitis

How well did you know this?

Not at all

Perfectly

Hip pain is typically found in what area?

a. anterior or lateral groin area
b. posterior or medial groin area
c. anterior or medial groin area
d. posterior or lateral groin area

anterior or medial groin area

How well did you know this?

Not at all

Perfectly

Lateral pain in the hip is usually _ or _ referred

trochanteric or L4 referred

How well did you know this?

Not at all

Perfectly

Pain that may be due to SIJ, piriformis or L5-S1 referred is found

a. anteriorly
b. posterior
c. medial
d. lateral

posterior

How well did you know this?

Not at all

Perfectly

Hip pain doesnt extend down the thigh towards the knee (true/false)

false

How well did you know this?

Not at all

Perfectly

This type of bursitis is usually due to direct trauma or repetitive friction from IT band over the greater trochanter during flexion/extension

a. trochanteric bursitis
b. ischial bursitis
c. iliopectineal bursitis
d. ITB bursitis

trochanteric bursitis

How well did you know this?

Not at all

Perfectly

This bursitis can be due to direct trauma or movement in sitting position

a. trochanteric bursitis
b. ischial bursitis
c. iliopectineal bursitis
d. ITB bursitis

ischial bursitis

How well did you know this?

Not at all

Perfectly

This bursitis is anterior hip pain and can be difficult to differentiate from hip flexor strain

a. trochanteric bursitis
b. ischial bursitis
c. iliopectineal bursitis
d. ITB bursitis

iliopectineal bursitis

How well did you know this?

Not at all

Perfectly

True hip pain is typically made worse by walking (True/false)

true

How well did you know this?

Not at all

Perfectly

Pain from the lumbar spine can be due to

a. L5, S1
b. L1, L2
c. L2, L3
d. L3, L4

L2-L3

How well did you know this?

Not at all

Perfectly

A patient presents with pain with weight bearing when they run, local pain, swelling and point tenderness over the greater trochanter, what could they be diagnosed with?

a. trochanteric bursitis
b. ITB bursitis
c. gluteus medius tendinosis
d. iliopectinal bursitis

trochanteric bursitis

How well did you know this?

Not at all

Perfectly

Patient presents with sharp pain over the greater trochanter that progresses to a dull ache with activity and may recur

a. trochanteric bursitis
b. ITB bursitis
c. gluteus medius tendinosis
d. iliopectinal bursitis

trochanteric bursitis

How well did you know this?

Not at all

Perfectly

What will you see in examination with trochanteric bursitis?

usually no signs of trauma 
ITB tight
increased Q-angle 
crepitus over trochanter 
resisted abduction may be painful and gluteus may be weak

How well did you know this?

Not at all

Perfectly

What will be seen with AROM and PROM with trochanteric bursitis?

pain AROM hip flexion and extension

pain with PROM flexion, IR and adduction

How well did you know this?

Not at all

Perfectly

What are possible causes of gluteus medius tendinosis/tendinopathy?

friction
alteration in gait
repetitive microtrauma

How well did you know this?

Not at all

Perfectly

GT bursitis may result from _

GT bursitis may result from tendinitis

How well did you know this?

Not at all

Perfectly

Ischial bursitis becomes painful and inflamed with _ _

excessive friction

How well did you know this?

Not at all

Perfectly

Is the ischial tuberosity point tender with ischial bursitis

yes

How well did you know this?

Not at all

Perfectly

Ischial bursitis is painful with A/PROM into _ and _

hip flexion - stretches it

hip extension - squeezes it

How well did you know this?

Not at all

Perfectly

What is iliopsoas bursitis most likely caused by?

repetitive hip flexion (running uphill)

Ilipsoas bursitis may refer to _ and _ dermatome a. L2 and L3 b. L1 and L2 c. L3 and L4 d. L5 and S1

L2 and L3

iliopsoas bursitis will produce pain with AROM

hip flexion and extension

iliopsoas bursitis will produce pain with PROM

hip extension

patients with iliopsoas bursitis may have tight

iliopsoas and rectus femoris

A contusion of the greater trochanter, iliac crest or ASIS from direct blow or landing on the hip

hip pointer

Hip pointer will have painful AROM

contralateral trunk side bending

Hip pointer will have painful PROM with

hip adduction, flexion (same side)

This is defined as spasm/hypertrophy of piriformis compresses "sciatic" nerve

piriformis syndrome

What are the potential causes of piriformis syndrome?

compression of the sciatic nerve muscle imbalances trauma strain or overuse

Patient describes buttock pain that progressed to posterior thigh and calf pain

piriformis syndrome

What aggravates piriformis syndrome?

walking extended sitting external rotation of the hip

Standing with the lower extremity _ will take out the piriformis

AROM with piriformis syndrome

SLR and hip ER cause pain

PROM with piriformis syndrome that causes pain

hip IR

Palpable tenderness in piriformis (true/false)

true

A micro tear, inflammation, pain with contraction and stretch, local pain is defined as a. 1st degree muscle strain b. 2nd degree muscle strain c. 3rd degree muscle strain d. none of the above

1st degree muscle strain

A macro tear, local pain and swelling followed by ecchymosis, spasm, pain with contraction and stretch is defined as a. 1st degree muscle strain b. 2nd degree muscle strain c. 3rd degree muscle strain d. none of the above

2nd degree muscle strain

A complete tear, palpable defect, severe pain, bruising, loss of function, and strength is defined as a. 1st degree muscle strain b. 2nd degree muscle strain c. 3rd degree muscle strain d. none of the above

3rd degree muscle strain

Muscle strains are typically associated with

dynamic overload to eccentric contractions

What is seen with muscle strains and AROM?

limited ROM, pain with contraction and stretching

What is seen with muscle strains and PROM?

pain with stretching muscle

Palpation with muscle strain

tenderness, possible defect

How should an acute muscle strain be treated?

rest, anti-inflammatory agents, physical agents, e-stim

How should sub-acute muscle strain be treated?

US, STM, gentle stretching

How should chronic muscle strains be treated?

STM, progressive strengthening, aggressive stretching, correction of muscle imbalances, gait retraining, functional training

Which type of strain is often a recurring problem?

HS strain

This type of muscle strain happens with eccentric load to muscle a. quad strain b. HS strain c. adductor strain d. hip flexor strain

HS strain

What needs to be addressed with a HS strain?

scar tissue | restoring elasticity and ballistic contractions

What is secondary to swelling with a HS strain?

neural tendon | eventual scar tissue near the sciatic nerve

This type of disorder is motion-related clinical disorder a. FAI syndrome b. HS strain c. labral tears d. quad strain

FAI syndrome

Symptoms of this disorder include motion-related or position-related pain in the hip or groin, pain in the back, butt, thigh, lateral hip or knee and potential clicking, catching, locking or stiffness a. FAI syndrome b. HS strain c. labral tears d. quad strain

FAI syndrome

Patients with this disorder describe pain with clicking, locking, stiffness and restricted ROM giving way a. FAI syndrome b. HS strain c. labral tears d. quad strain

FAI syndrome

What is the most commonly used clinical test for FAI syndrome?

FADIR

Patients are typically limited in what motions with FAI syndrome?

internal rotation with flexion

What causes FAI syndrome?

acetabulum and/or femoral head do not develop correctly

A patient presents with groin pain and or pinching sensation, pain in the posterior/lateral hip and C-sign, their symptoms line up with a. HS strain b. OA c. muscle strain d. FAI

FAI

What does imaging of the FAI look for?

cam morphology | pincher morphology

flattening or convexity at the femoral head/neck junction a. cam morphology b. pincher morphology c. labral tear d. FAI

cam morphology

global or focal over-coverage of the femoral head by the acetabulum a. cam morphology b. pincher morphology c. labral tear d. FAI

pincher morphology

both cam and pincher morphology can be present in patients with

FAI

presence of cam or pincher morphology without symptoms and signs is not FAI syndrome (true/false)

true

Rehab care for FAI goal

improving hip stability neuromuscular control strength ROM and movement patterns

labrum deepens the socket adding _ to the hip joint as well as _ to the joint itself

stability | cushioning

What are ways the labral ligament can be torn?

degenerative | traumatic

This type of labral tear is due to repetitive minor injuries and are often associated with arthritis of the hip

degenerative labral tear

This type of labral tear can occur with rapid hip motion or sudden stops and turns

traumatic labral tear

Where is pain usually located with a labral tear? a. outer hip b. medial and anterior hip c. lateral and posterior hip d. inner hip or groin area

inner hip or groin area

This injury has a catching sensation within the joint and little to no pain during normal daily activities

labral tear

Labral tear indicates tenderness with a. ER and flexion b. IR and extension c. abduction and flexion d. adduction and IR

IR and extension

What motion reproduces catching sensation in a labral tear? a. flex and adduction b. IR and adduction c. flex and abduction d. ER and adduction

flex and abduction

Which test reproduces the clicking sensation with a labral tear?

thomas test

Pain with labral tear shown in what ROM?

flexion and adduction

What are the functional tests for the hip and pelvis?

deep squat cross leg sitting stair ambulation single leg stand

Deep squat functional test is looking for a. ability to get knees over toes b. ability to bend knees and pelvis c. ability to complete with the symmetrical movement of hips and knees d. ability to get hips down far enough

ability to complete with the symmetrical movement of hips and knees

Cross leg sitting functional test is looking for a. ability to cross one leg over the other b. ability to cross both legs criss cross applesauce c. ability to place lateral malleolus and distal leg on the opposite anterior distal thigh d. none of the above

ability to place lateral malleolus and distal leg on the opposite anterior distal thigh

Stair ambulation for a functional test requires a. ability to ascend stairs b. ability to descend stairs c. ability to ascend and descend 6" stairs d. ability to ascend and descend 8-12" stairs

ability to ascend and descend 8-12" stairs

Single leg stand functional test is looking at the

assessment of proprioceptive abilities kinesthetic awareness and control balancing abilities reproduction of SIJ symptoms

What 3 tests would indicate a labral tear if they are positive?

clicking in the hip IR-flexion-compression thomas test

Hip and Pelvis Soft Tissue Flashcards

(83 cards)