hip conditions Flashcards

1
Q

what type of conditions can cause hip problems

A
Vascular
Infective/inflammatory
Trauma
Autoimmune
Metabolic
Iatrogenic
Neoplastic
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2
Q

what is femoroacetabular impingement syndrome

A

altered morphology of femoral neck and/or acetabular

-causes abutment of the femoral neck on the edge of the acetabulum during movement

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3
Q

what are the two types of impingement in FAI

A
  • CAM type

- pincer type

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4
Q

what is a cam type impingement

A

femoral deformity

-asymmetric femoral head with decreased head:neck ratio

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5
Q

who gets cam type impingement

A

young athletic males

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6
Q

what is pincer type inpingement

A
  • acetabular deformity

- acetabular overhang

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7
Q

who gets pincer type impingement

A

females

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8
Q

what do both types of impingement cause

A
  • damage to the labrum and tears
  • damage to cartilage
  • OA in later life
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9
Q

presentation of FAI

A
  • activity related pain in groin
  • flexion and rotation pain
  • difficulty sitting
  • C sign positive
  • FADIR provocation test positive
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10
Q

diagnosis of FAI

A
  • radiographs
  • CT
  • MRI
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11
Q

management of FAI

A
  • observation in asymptomatic
  • arthroscopic or open surgery to remove CAM/debride laberal tears
  • peri-articular osteotomy/debride labral tears in pincer impingement
  • arthroplasty older patients with secondary OA
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12
Q

what is avascular necrosis

A

failure of blood supply to the femoral head

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13
Q

pathophysiology of avascular necrosis

A
  • coagulation of the intraosseous microcirculation
  • venous thrombosis
  • intraosseous hypertension
  • decreased blood flow to femoral head
  • necrosis of head
  • chondral fracture and collapse
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14
Q

who gets avascular necrosis

A

males

35-50

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15
Q

risk factors of avascular necrosis

A
  • irradiation
  • trauma
  • hematologic disease
  • sickle cell
  • dysbaric disorders
  • alcoholism
  • steroids
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16
Q

presentation of avascular necrosis

A
  • insidious onset of groin pain

- worse on stairs and impact

17
Q

diagnosis of avascular necrosis

A
  • radiographs

- MRI

18
Q

what shows irreversible avascular necrosis on a radiograph

A
  • crescent sign
  • flattening of femoral head
  • narrowing of joint
  • advanced degenerative changes
19
Q

management of avascular necrosis

A
  • bisphosphonates
  • core decompression +/- bone grafting
  • curettage and bone grafting
  • vascularised fibular bone graft
  • rotational osteotomy
  • total hip replacement
20
Q

what is trochanteric bursitis

A

repetitive trauma cause by iliotibial band tracking over trochanteric bursa
-inflammation of bursa

21
Q

who gets trochanteric bursitis

A
  • female
  • young runners
  • any age
22
Q

presentation of trochanteric bursitis

A
  • pain on lateral aspect of hip

- pain on palpitation of greater trochanter

23
Q

diagnosis of trochanteric bursitis

A

-clinical diagnosis

24
Q

management of trochanteric bursitis

A
  • analgesia
  • NSAIDs
  • physio
  • steroid injection
25
Q

who gets OA

A

females
old
pre-existing hip disease

26
Q

presentation of OA

A
  • groin pain
  • worse on activity
  • pain at night
  • start up pain
  • stiff on testing range of motion
27
Q

diagnosis of OA

A

radiographs

28
Q

what are the radiographic signs of OA

A
  • joint space narrowing
  • subchondral sclerosis
  • osteophytes
  • cyst formation
29
Q

management of OA

A
  • analgesia
  • weight loss
  • walking aids
  • physio
  • steroid injections
  • total hip arthroplasty
30
Q

what are the types of prothesis for a total hip arthroplasty

A
  • cemented
  • uncemented
  • hybrid
31
Q

what are the bearing choices for hip replacements

A
  • metal on poly
  • ceramic on poly
  • ceramic on ceramic
32
Q

risks of hip replacement

A
  • scar
  • bleeding
  • neurovascular injury
  • fracture
  • clotting
  • infection
  • dislocation
  • leg length discrepancy
  • loosening
  • ongoing symptoms
33
Q

is cemented used in older or younger patients

A

older

34
Q

is hybrid used in younger or older

A

younger