Hip/Groin

Question 1

What artery should be considered in groin pain?

Answer 1

External iliac artery

Question 2

Patient complains of thigh discomfort during cycling, only during high intensity. No reproducible pain on testing.

What is a potential red flag diagnosis?

Answer 2

External iliac artery compression

Question 3

What are the 3 recommendations from the Warwick agreement

Answer 3

1. A negative FADIR helps to rule out hip pathology
2. imaging should not be used in isolation
3. X-rays are useful to aid diagnosis

Question 4

List red flags for the hip/groin region (7)

Answer 4

1. Cancer history
2. Visceral referral
3. Trauma
4. Fever
5. Painful urination
6. Night pain
7. Prolonged steroid use

Question 5

What is a useful objective measure for ruling out avascular necrosis in the hip/groin?

Answer 5

Hip rom

Question 6

Two ways to rule out a stress fracture?

Answer 6

1. Fulcrum test
2. Hop test

Question 7

True or false: x-ray is useful for a vascular necrosis ?

Answer 7

True

Question 8

True or false: x-ray is useful for stress # ?

Answer 8

False. Only if really late stage

Question 9

Is the thigh thrust test sensitive or specific ? Give values

Answer 9

Sensitive - 88%

Question 10

Pubic-related groin pain is more likely if what objective finding is present?

Answer 10

1. Pain on resisted adductor and abdominal testing

Question 11

Pubic-related groin pain can be treated the same as…….?

Answer 11

ARGP

Question 12

How do you test the deep neck flexors ?

Answer 12

Craniocervical flexion test

Question 13

What is an appropriate and evidenced based way to measure RSI and athletic groin pain?

Answer 13

Drop jump RSI

Question 14

In the study by Baida, with treatment, what was the average RTP time for those with AGP ?

Answer 14

9 +/- 3 weeks

Question 15

What did Thorborg find in regard to abd/add ratio?

Answer 15

Found no difference between injured and controls

Question 16

What is the consensus paper for classifying intra-articular groin pain?

Answer 16

Zurich agreement

Question 17

When measuring pelvic tilt on an x-ray, what’s the normal degree of anterior tilt? Why’s it relevant?

Answer 17

1-3cm

Gives a false picture of acetabular retroversion

Question 18

What is the more common FAI?

Answer 18

Cam-type

Growth in femoral neck

Question 19

What alpha angle tends to be more associated with symptoms in FAI and would be considered “large”?

Answer 19

> 78 alpha angle

Question 20

At what age does the growth plate around the femoral neck close in males?

Answer 20

14-15

Question 21

At what age does the femoral neck growth generally close in females ?

Answer 21

11-12years

Question 22

If suspecting hip dysplasia, what x-ray views should you request?

Answer 22

1. AP pelvis
2. False profile view

Question 23

Decreased hip IR, increased ER could indicate what?

Answer 23

Acetabular/femoral retroversion

Question 24

What test MIGHT be useful to for suspected FAI? State whether is sensitive or specific.

Answer 24

Prone IR

Specific

Question 25

What test MIGHT be useful for suspected labral tear? State whether is sensitive or specific.

Answer 25

Thomas test Both specific and sensitive

Question 26

What test MIGHT be useful for suspected ligamentum teres injury? State whether is sensitive or specific.

Answer 26

Ligamentum teres test Both sensitive and specific

Question 27

What is a negative result for prone IR test

Answer 27

Normal rom. Can still have pain w/ negative

Question 28

Increased hip IR and reduced hip ER, could indicate what? And what’s the cut off score for “different” in side to side comparison ?

Answer 28

Anteversion Greater than 20 degrees difference

Question 29

According to systematic reviews, what are the most commonly seen impairments in FAI?

Answer 29

1. Decreased hip strength 2. Bilateral decreased trunk strength 3. Decreased hop distance (-9cm) 4. Decreased one leg rise (-7cm)