hip pathology

Question 1

acetabulum

Answer 1

faces laterally, inferiorly, and anteriorly

Question 2

labrum

Answer 2

inverted horseshoe shaped cartilage
enhances joint stability, decreased forces transmitted to articular cartilage, provides proprioceptive feedback
majorly avascular

Question 3

femur

Answer 3

strongest and longest bone
2/3 of head covered in cartilage
head angled ant, sup, and med

Question 4

ward triangle

Answer 4

point on femur of weakness of trabecular system, common site for osteoporotic fracture

Question 5

iliofemoral ligament

Answer 5

strongest ligament in the body
limits range of hip extension
allows for maintenance of upright posture

Question 6

pubofemoral ligament

Answer 6

tightens with extension and abduction

Question 7

ischiofemoral ligament

Answer 7

tightens with internal rotation

injured more than the other hip ligaments

Question 8

ligamentum teres

Answer 8

attaches femoral head to inf acetabular rim

tightens during adduction, flexion, and ext rotation

Question 9

femoral triangle

Answer 9

inguinal ligament
add longus
sartorius
iliopsoas and pectineus
femoral vein, artery, nerve

Question 10

normal coxa

Answer 10

125

Question 11

coxa vara

Question 12

coxa valgus

Answer 12

> 140
increases length of LE
increase compressive forces to the joint
shortens moment arm of hip abductors

Question 13

normal torsion angle

Answer 13

8-15

Question 14

anteversion

Answer 14

> 15
end range ext rot
compensate with walking toe in

Question 15

retroversion

Question 16

open packed position of the hip

Answer 16

30 flexion
30 abduction
slight ext rot

Question 17

closed packed position

Answer 17

max extension
internal rotation
slight abduction

Question 18

capsular pattern

Answer 18

flexion=abduction=IR, slight loss extension, little to no loss in ER

Question 19

hip flexion glide

Answer 19

post

Question 20

hip extension glide

Answer 20

ant

Question 21

hip abduction glide

Answer 21

inf

Question 22

hip add glide

Answer 22

sup

Question 23

hip int rot glide

Answer 23

post

Question 24

hip ext rot glide

Answer 24

ant

Question 25

hip abduction glide with hip at 90

Answer 25

ant

Question 26

hip add glide with hip at 90

Answer 26

post

Question 27

hip int rot glide with hip at 90

Answer 27

inf

Question 28

hip ext rot glide with hip at 90

Answer 28

sup

Question 29

flex/ext needed for sit to stand

Answer 29

80 | 100

Question 30

flexion needed to climb stairs

Answer 30

60

Question 31

needed for descent of same stair

Answer 31

24-30

Question 32

flexion during late swing of gait

Answer 32

35-40

Question 33

ext during heel off

Answer 33

full ext

Question 34

X-ray of OA

Answer 34

bones will be closer together, cysts or fluid filled cavities form as cartilage destructs increase bone density or uneven joints (bone spurs)

Question 35

OA pain

Answer 35

groin, buttock, thigh or knee aching to sharp C sign stiffness

Question 36

capsular pattern

Answer 36

restriction flexion=abduction=IR, slight loss of extension, little to no loss ER 50 yo

Question 37

AVN

Answer 37

30-50 years old pain in groin, proximal thigh or button loss of ROM in all directions CORTICOSTEROIDS, chemo, trauma

Question 38

most common cause mechanical hip symptoms

Answer 38

``` labral tear (ant sup) ant groin pain, thigh, medial knee, trochanteric or buttock pain pain with active straight leg raise pain at ends of ROM but no loss in ROM clicking, catching, locking ```

Question 39

FAI

Answer 39

cam- femoral head has large radius pincer- over coverage of acetablum correlated with labral tears

Question 40

myositis ossificans

Answer 40

can occur post trauma abnormal formation of bone between muscle fibers PROM or stretching contradicted bc can tear

Question 41

one of the most common muscle injuries

Answer 41

hamstring

Question 42

adductor muscle injury

Answer 42

``` pain in groin add mag and longus most common increased pain with twisting quick start and stop pain with passive abduction and resisted adduction ```

Question 43

add gracilis injury resisted motion

Answer 43

leg straight

Question 44

add long/brevis resisted motion

Answer 44

hip 45

Question 45

pectineus resisted motion

Answer 45

hip 90

Question 46

iliopsoas injury

Answer 46

injury often from forced ext while it is actively flexing pain with acceleration and high stepping pain with resisted hip flexion, adduct

Question 47

gluteus medius injury

Answer 47

pain in button, lat hip, groin tend gait weakness

Question 48

sciatica

Answer 48

restricted in hip adduction, IR | positive FABER

Question 49

post lat hip approach precautions

Answer 49

no flex past 90 no adduction past midline no internal rotation past neutral

Question 50

ant lat approach precautions

Answer 50

``` may not have restrictions no ext beyond neutral no ext rot beyond neutral no extreme abduction no flexion past 90 ```

Question 51

slipped femoral capital epiphysis

Answer 51

``` slow onset ant displacement of femoral neck males 10-17 females 8-15 african americans > whites knee, lower thigh, groin or medial thigh dec int rot, abd, flex may ONLY report pain in MED knee ```

Question 52

Legg Calve perthes disease

Answer 52

``` increased density, fragmentation and flattening of epiphysis center hip, knee, or groin pain insidous onset lower age range than SCFE 2-13 yo males > female usually unilateral ```

Question 53

transient synovitis

Answer 53

``` most common cause of sudden hip pain in children 2-12 yo males > females lasts short time only one limb inflammation and swelling of the tissues unknown cause ```