Hip Examination Flashcards Preview

PT 515 Musculo > Hip Examination > Flashcards

Flashcards in Hip Examination Deck (49):
1

Percentage of patients with knee OA that have Hip OA

40%

2

WOMAC

Lower extremity scale

3

Harris Hip Score

Scored by PT
Pain, Gait, Mobility, Deformity (ROM Loss)

4

LE Functional Scale

20 functional activities

Each rated 0 (Unable to perform) to 4 (No Difficulty)

Sensitive to change-->9 points minimal level of detectable change

Out of 80 points

5

Pain location of OA in the hip

1) Greater Trochanter
2) Anterior Thigh
3) Knee Region
4) Groin

6

L1 Dermatome Point

Inguinal Line

7

L2 Dermatome Point

Anterior Proximal Thigh

8

L3 Dermatome Point

Anterior distal thigh

9

L4 Dermatome Point

Medial distal Leg

10

L5 Dermatome Point

Lateral Leg

11

S1 Dermatome Point

Lateral dorsum of foot

12

Ward's Triangle

Weak part of neck of femur due to lack of trabeculae

13

Risks for Osteoporosis

Women >65 who weigh less than 140 at menopause or never used estrogens for >6 months

14

Kellgren Lawrence Radiographic grade

Scale of joint space narrowing

Baseline grade is important predictive factor for having a THA

15

Grade I Kellgren/Lawrence

Doubtful narrowing of joint space and possible osteophytic lipping

16

Grade II Kellgren/Lawrence

Definite Osteophytes, definite narrowing of joint space

Strong predictor of hip OA progression

17

Grade III Kellgren/Lawrence

Moderate multiple osteophytes, definite narrowing of joint space, some sclerosis and possible deformity of bony contour

.3 odds ratio of having a THA

18

Grade IV Kellgren/Lawrence

Large osteophytes, marked narrowing of joint space

5.3 odds ratio that pt. would have a THA

19

Sign of the Buttock

Positive is a Red Flag
Straight leg raise equal leg flexed or extended

Possible neoplasm, septic bursitis, sacral fx, ischiogluteal bursititis

20

GI Red Flags

Nausea, vomiting, abdominal pain, changes in bowel function, blood in stool, tests for psoas abscess

21

Vascular Red Flags

Throbbing, varicose veins, trophic changes, Hx. of heart disease

22

Infectious Red Flags

IBD such as Crohn's, ulcerative colitis, diverticulitis, appendicitis, recent skin rashes

23

Cancerous

Previous hx of cancer, bone night pain, night sweats, palpate the lymph nodes

24

Gait component measures

Step length, stride length, fick angle, speed

25

Blind Stance WB

pt looks straight ahead and stands on two scales

26

FTPO

Only works if pain is abolished when leaning opposite
If pain is abolished when leaning away, lean to until pain

27

LE Alignment

Compensated Anteversion: Toe in
Compensated Retroversion: Toe out
Posterior Dislocation: Short/Adducted/IR
Anterior Dislocation: Abducted/ER
Intertrochanteric Fx: Short/ER

28

Weber-Barstow Maneuver

pt supine
Hip bridge then drop down
PT pulls legs out
Compare with thumbs on medial malleoli

29

Prone Knee Flexion Test for tibial shortening

pt prone
Neutral ankle
Look at level of plantar surface of feet

30

Flexion ROM

0-120°

31

Extension ROM

0-20°

32

Abduction ROM

0-45°

33

Adduction ROM

0-30°

34

IR ROM

0-45°

60-90° if anteverted

35

ER ROM

0-45°

36

Open Pack Position

30° flexion
30° abduction
Slight ER

This is a position of bony approximation

37

PROM

When AROM isnt full and pain free

38

Hip capsular pattern

Limitation in flexion, abduction, and IR

39

3 most commonly limited motions with hip OA

IR/ER
Flexion

40

Closed Pack Position

Full Extension
Full IR

41

Coxa Saltans Internal Snapping

1) Iliopsoas over lesser trochanter or anterior acetabulum
2) Iliofemoral ll over femoral head
Both commonly cause snap at 45 when extending from flexed position

42

Coxa Saltans External Snapping

1) ITB over Greater Trochanter
2) Gluteus Maximus over Greater Trochanter
Palpated lateral during hip flexion and extension

43

Coxa Saltans Intra-articular Snapping

Acetabular Labral Tear/Loose Body
-Often present with sharp pain in groin and anterior thigh especially with pivoting motions

44

Functional Step Up/Step Down Testing

Up with the bad
Down with the good

45

Activity Limitation and Participation Restriction Measures

6 minute walk test
Self-Paced Walk Test- 400m walk
Stair Measure- 20 steps on 6 inch block timed
Timed Up and Go Test- Stand walk 3m and back and sit

46

Ortolani's Test

-Infant supine
-Grasp thighs with thumbs medially and fingers laterally at greater trochanter
-Gentle traction, abduction, and med directed pressure on greater trochanter
-Looking for reduction
Valid first 1-3 weeks of birth for dislocated/subluxed hips

47

Causes of Intoeing Gait in Children

Femoral Anteversion
Internal tibial torsion
Metatarsus Adductus

48

Children Femoral Anteversion

Born with ~40°
2:1 Females to males
Derotational femoral osteotomy at 8-9 y/o

49

Derotational Femoral Osteotomy

Femoral anteversion >45°
Absent ER
Functional disability or severe cosmetic deformity