Hip ppt

Question 1

What is the minimum palpation for every pt with hip pain?

Answer 1

iliac crest at L4
anterior superior iliac crest
greater trochanter

Question 2

musculoskeletal differential for anterior hip pain

Answer 2

meralgia paresthesia

sports hernias

Question 3

musculoskeletal differential for anterolateral hip pain

Answer 3

femoroacetabular impingement
hip labral tear
legg calve perthes disease
osteoarthritis
osteonecrosis of hip
septic hip
slipped capital femoral epiphysis

Question 4

musculoskeletal differential for lateral hip pain

Answer 4

external snapping hip

greater trochanteric bursitis

Question 5

musculoskeletal differential for posterolateral hip pain

Answer 5

gluteal muscle tear

iliac crest apophysis avulsion

Question 6

musculoskeletal differential for posterior hip pain

Answer 6

hamstring strain
ischiofemoral impingement
piriformis syndrome
sacroiliac joint dysfunction

Question 7

What do you perform the FABER test to test?

Answer 7

labral tear, loose bodies, chondral lesions, femoral acetabular impingement, osteoarthritis, sacroiliac joint dysfunction, iliopsoas bursitis

Question 8

When do you use the FABER test?

Answer 8

anterolateral/anterior hip pain

Question 9

When do you use the FADIR test?

Answer 9

anterior hip pain

Question 10

What does the FADIR test test for?

Answer 10

labral tear, loose bodies, chondral lesions, femoral acetabular impingement

Question 11

What does the log roll test for?

Answer 11

piriformis syndrome

SCFE

Question 12

What does the straight leg raise test test for?

Answer 12

sports hernia
SCFE
femoral acetabular impingement

Question 13

When do you use the straight leg raise test?

Answer 13

anterior/anteriolateral hip pain

Question 14

When do you use the Ober test?

Answer 14

lateral hip pain

Question 15

What is the Ober test for?

Answer 15

external snapping hip, greater trochanteric pain syndrome

Question 16

What does the Trendelenburg gait indicate?

Answer 16

labral tear, transient synovitis, Legg-Calve-Perthes disease

gluteus medius m

Question 17

What is the Thomas test for?

Answer 17

tendinopathy, rectus femoris tear, fractures

Question 18

What is the PACE test/FAIR test for?

Answer 18

piriformis syndrome

Question 19

development dysplasia of the hip tests

Answer 19

Ortolani test - abducting forward
Barlow - adducting posteriorly
+ clunk or dislocation
needs bracing, US hip to confirm

Question 20

trochanteric bursitis
Where is the pain?
risk factors

Answer 20

most common cause of lateral hip pain, over greater trochanter
tendinopathy of the gluteus minimus and medius, also involves inflammation of bursa
female gender, obesity, knee pain, IT band tenderness, low back pain

Question 21

PE finding for trochanteric bursitis

Answer 21

lateral hip pain, especially when lying on affected side, local tenderness on the greater trochanter
specialty test: may have + FABER and Ober tests

Question 22

osteonecrosis of hip
causes
mechanism

Answer 22

medications (longterm steroid use), medical conditions (sickle cell anemia, SLE), trauma, transplantation
decreased or poor blood supply, mechanical trauma, genetic factors, metabolic factors

Question 23

PE findings for osteonecrosis of hip

Answer 23

groin pain, pain with activity, pain at rest

my be asymptomatic after a while

Question 24

imaging for osteonecrosis of hip

Answer 24

XR initially

MRI

Question 25

treatment of osteonecrosis of hip

Answer 25

medications: bisphosphonates (can cause osteonecrosis of jaw), vasodilators, statin (lipid lower drugs), anticoagulation osteotomy grafting surgical fixation (total hip replacement)

Question 26

Legg-Calve-Perthes disease who does it affect? risk factors

Answer 26

idiopathic avascular necrosis of the hip, decreased perfusion to the femoral head affects children 3 - 12 yo, males>females skeletal immaturity, obesity, lower socioeconomic status

Question 27

PE findings Legg-Calve-Perthes disease

Answer 27

acute or insidious onset of pain with limping, decreased ROM or stiffness

Question 28

imaging for Legg-Calve-Perthes disease

Answer 28

XR shows osteochondral loose bodies

Question 29

treatment for Legg-Calve-perthes disease

Answer 29

nonweightbearing with sling, surgery

Question 30

slipped capital femoral epiphysis (SCFE) | cause/risk factor

Answer 30

pain and limitation in movement of limb due to femoral epiphysis that slipped posteriorly obesity in adolescent (8-15 yo) growth spurt, endocrine disorder

Question 31

SCFE PE findings

Answer 31

obese adolescent presenting with hip pain with limping and impaired internal rotation, occasionally after minor trauma

Question 32

imaging for SCFE

Answer 32

AP or lateral view XR of hip, US, MRI

Question 33

treatment for SCFE

Answer 33

nonweight bearing with crutches or wheelchair, refer to ortho surgery to stabilize and prevent complications

Question 34

femoraoacetabular impingement

Answer 34

pain on anterolateral hip/groin due to abnormal contact btwn the anterior femoral head and acetabular rim can increase risk of osteoarthiritis of hip

Question 35

PE findings of femoraoacetabular impingement

Answer 35

pain increased with prolonged sitting, leaning forward, getting out of car insidious pain in groin area and buttocks

Question 36

specialty testing for femoraoacetabular impingement

Answer 36

C-sign, positive FABER and FADIR test

Question 37

treatment for femoraoacetabular impingement

Answer 37

physical therapy inraarticular injection arthroscopy

Question 38

acetabular labral tear causes can hasten...

Answer 38

pain on anterior aspect of hip post trauma or insidious in onset (from longterm microtrauma) ...osteoarthritis

Question 39

PE findings of acetabular labral tear | specialty test

Answer 39

pain with activity | + Thomas test

Question 40

imaging for acetabular labral tear

Answer 40

MR arthrography

Question 41

treatment for acetabular labral tear

Answer 41

joint injection and hip arthroscopy

Question 42

What are common organisms for septic arthritis? healthy people immunocompromised pt

Answer 42

healthy: staph aureus and streptococcal, N gonorrhea immunocompromised: gram - bacteria, mycobacterial species, fungal species

Question 43

piriformis syndrome | causes

Answer 43

entrapment of the sciatic N resulting in pain on buttock may develop after trauma to buttock or piriformis muscle causing strain and scarring around the nerve structure of piriformis muscle

Question 44

PE findings of piriformis syndrome | specialty test

Answer 44

``` buttock pain and paresthesia wallet sign: pain with sitting on wallet neurologic exam normal + log roll test + PACE test/FAIR test ```

Question 45

treatment for piriformis syndrome

Answer 45

physical therapy | nerve pain medications

Question 46

meralgia paresthetica | causes

Answer 46

compression of the lateral femoral cutaneous nerve as it passes through the inguinal ligament pain on the lateral aspect of hip and thigh tight fitting clothes, obesity, DM, pregnancy

Question 47

PE findings of meralgia paresthica | specialty test

Answer 47

numbness and tingling or decreased sensation over the lateral hip and thigh + FABER

Question 48

treatment for meralgia paresthetica

Answer 48

conservative therapy nerve block nerve pain with neuropathic pain