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hip conditions Flashcards

1
Q

what are the s&s of AVN in the hip?

A

deep, dull hip pain
limp/waddling gait
decreased ROM (particularly internal rotation)

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2
Q

what are the possible causes of AVN?

A

Pancreatitis/pregnancy
Lupus (SLE)
Alcoholism/atherosclerosis
Steroids
Trauma (eg. femoral neck fracture)
Infections/idiopathic (legg-calve perthes’ disease)
Collagen vascular disease

RA/ radiation therapy
Amyloid(osis)
Gout
Sicke cell disease

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3
Q

what are s&s of trochanteric bursitis?

A

aching lateral hip pain (may radiate to groin and lateral thigh)

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4
Q

what are the findings in the physical exam for trochanteric bursitis

A

weak hip flexors
tight ITB
PROM: abduction and external rotation painful
RROM: abduction painful
+ve fabere’s test

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5
Q

what are aggravating factors for trochanteric hip bursitis?

A

prolonged standing
lying on affected side
climbing stairs
running

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6
Q

what are possible treatment options for trochanteric bursitis?

A

trigger points of affected muscles
Ober’s PIR
hamstring PIR
US or electrical stimulation options

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7
Q

what are s&s of ischial bursitis?

A

unilateral pain while seated
pain around ischial tuberosity

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8
Q

what are treatment options for ischial bursitis?

A

trigger point therapy to ischial tuberosity
hamstring PIR
US or electrical stimulation options

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9
Q

what are the s&s of iliopsoas bursitis?

A

anterior hip and/or groin pain
worse with leg extension
better with flexion-external rotation (fabere position)

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10
Q

what is hip capsulitis?

A

adhesion within the hip capsule and surrounding structures

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11
Q

what are s&s of hip capsulitis?

A

insidious, rapid onset of pain and stiffness
pain worse with activity
decreased ROM (flexion-adduction, rotation+hyperextension the earliest loss)
pain settles over several months but stiffness improves more slowly

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12
Q

what is a disordered hip complex?

A

complex signs and symptoms of myofascial origin causing anterior hip pain and anterior impingement

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13
Q

what are possible causes of disordered hip complex?

A

prolonged hip flexion (sitting)
adductor or psoas strain
repetitive hip flexion during gait

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14
Q

what are s&s of disordered hip complex?

A

pain in groin/buttock
weak hip flexors (difficulty climbing stairs)

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15
Q

what are the most common muscles involved in a disordered hip complex?

A

iliopsoas
adductors

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16
Q

what is femoral-acetabular impingement?

A

impingement of the psoas or rectus femoris tendons between the femur and acetabulum

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17
Q

what is type 1 or cam impingement?

A

change in femoral head shape (bony bumps on superior aspect)
MC in young athletes
may abrese the acetbular cartilage –> riks of labral tear

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18
Q

what is type 2 or pincer impingement?

A

abnormally deep acetabulum or osteophyte formation
slow onset, intermittent groin pain
decreased and painful hip extension
+ve flexion-adduction test
+ve FAIR test

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19
Q

what is the female athlete triad?

A

amenorrhea (absence of menstruation)
eating disorder
osteoporosis

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20
Q

what are s&s of a stress fracture of the hip?

A

pain progressing with activity
focal area of tenderness, erythema, swelling and warmth

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21
Q

which special test can indicate a hip stress fracture?

A

single leg hop test

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22
Q

what is the imaging of choice for a stress fracture?

A

x-ray
if normal, bone scan (+ve within 48-72 hours after injury)

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23
Q

who is most at risk for pubic ramus stress fracture?

A

long distance runners

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24
Q

what are s&s of pubic ramus fracture?

A

pain in inguinal/perianal/adductor region
cannot bear weight on affected side
antalgic gait
normal hip ROM
very tender around pubic ramus

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25
Q

who is most at risk for a femoral neck stress fracture?

A

long distance runners
female athletes (female athlete triad)

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26
Q

what are s&s of a femoral neck stress fracture?

A

pain in groin/anterior thigh
pain related to activity
antalgic gait
reduced ROM (especially internal rot)
pain on axial compression
pain on end range in external rotation

27
Q

what are s&s of femoral shaft fracture?

A

groin pain
worse with activity
pain at night
+ve fulcrum test

28
Q

which condition can mimic trochanteric bursitis?

A

gluteus medius tendinopathy

29
Q

how can we distinguish between trochanteric bursitis and a gluteus medius tendinopathy?

A

in a gluteus medius tendinopathy the TTP area is superior to the greater trochanter

30
Q

what are possible causes of gluteus medius overload?

A

ankle hyperpronation
ITB syndrome
leg lengTH

31
Q

what is an inguinal or femoral hernia?

A

part of the intestine herniates through a weak part of the transverse abdominis

32
Q

what are s&s of inguinal hernia?

A

pain in area of herniation (superior and medial to pubic tubercle)
pain may radiate to upper thigh or scrotal region
pain worse with Valsalva manoeuvres

33
Q

what are s&s of femoral hernia?

A

pain in area of herniation (inferior and lateral to pubic tubercle)
pain may radiate to upper thigh and scrotal region
pain worse with Valsalva manoeuvres

34
Q

what is the management for inguinal or femoral hernia?

A

surgical referral

35
Q

what is a iliac crest contusions?

A

bruise over iliac crest due to direct trauma

36
Q

what are s&s of labral tear?

A

sharp anterior hip/groin pain
deep clicking in the hip
feeling like the joint is giving away
+ve FAIR test

37
Q

what is the imaging of choice for a labral tear?

A

MRI

38
Q

what is the most common hip adductor injury?

A

adductor longus strain

39
Q

what causes an adductor longus strain?

A

forced external rotation of the hip

40
Q

what are s&s of an adductor longus strain?

A

sudden, stabbing pain in groin
swelling and bruising over origin or insertion of muscle
pain on passive stretch of muscle
pain on resisted adduction

41
Q

what is the treatment for adductor longus strain?

A

RICE
myofascial release
exercises as soon as pain allows
NSAIDs

42
Q

what are s&s of a rectus femoris strain?

A

sudden, stabbing pain over anterior acetabulum
swelling and bruising over muscle
pain on passive stretching of muscle
pain on resisted hip flexion

43
Q

in which type of athletes is an iliopsoas strain common?

A

weight lifting
uphill running
sit ups

44
Q

what are s&s of iliopsoas strain?

A

sudden, stabbing pain over groin
swelling and bruising over muscle
pain on passive stretching of muscle
pain on resisted hip flexion at 90°

45
Q

what are s&s of rectus abdominis strain?

A

sudden, stabbing pain over pubic symphysis
swelling and bruising over muscle
pain on actively lifting legs or head while supine

46
Q

what condition can rectus abdominis strain mimic and how can you differentiate between those two?

A

appendicitis
if pain related to muscle contracture –> strain

47
Q

what is osteitis pubis?

A

instability/inflammation of the symphysis between the two pubic bones

48
Q

in which athletes is osteitis pubis common?

A

football players
runners

49
Q

what are s&s of osteitis pubis?

A

BL groin pain
pain on extension and adduction of thigh
clicking during certain movements
‘unable to kick a football’
secondary Trp’s in stabilising muscles (adductor longus and rec fem)
BL pubic symphysis TTP
+ve single leg standing
+ve single leg hyperextension
pain in PROM abduction and RROM adduction

50
Q

what are the x-ray findings of osteitis pubis?

A

sclerosis and irregularity of the pelvic bone at the symphysis pubis

51
Q

what are s&s of hip OA?

A

hip pain
morning stiffness (<30 min)
antalgic gait
reduced ROM (especially internal rot)

52
Q

what are the x-ray findings in hip OA?

A

non-uniform loss of joint space
osteophyte formation
subchondral cyst
subchondral scleroris
buttressing
joint deformity

53
Q

what are s&s of osteoid osteoma?

A

night pain
pain relieved by NSAIDs

54
Q

what are s&s of a ilioinguinal neuralgia?

A

burning/shooting pain in the base of penis to medial thigh
pain around ASIS
loss of soft tissue perception in medial thigh
pain worse in hyperextension of leg

55
Q

what are the causes of an ilioinguinal neuralgia?

A

trauma
abdominal muscle training
inflammatory conditions

56
Q

what is the cause of an obturator neuralgia?

A

exercise: running, twisting, kicking

57
Q

what are the s&s of an obturator neuralgia?

A

insidious onset pain at adductor origin (pubic tubercle) into the groin
POC produced with pectineus stretch

58
Q

what is the cause of genitofemoral neuralgia?

A

excessively tight clothing over the inguinal ligament

59
Q

what are s&s of genitofemoral neuralgia?

A

pain on proximal thigh/groin just under the inguinal ligament
pain worse in hip extension
pain worse with pressure over inguinal hernia

60
Q

what is the snapping hip syndrome?

A

a condition covering ddx’s that cause clicking of the hip

61
Q

what is the most common cause of a snapping hip?

A

snapping of the ITB/TFL muscle over the greater trochanter

62
Q

what is a sports hernia?

A

a strain or tear of any soft tissue (muscle, tendon, ligament) in the lower abdomen or groin area.

63
Q

what are s&s of sport’s hernia (Gilmore’s groin)?

A

groin pain during sports
hard to localise groin pain
pain may radiate to adductors or testicles
stiffness and soreness after sports (day after)
pain on coughing, squeezing legs together and sitting up from lying

conditions (29 decks)

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