Hip Study Guide

Question 1

Femoral

Answer 1

L2-L3

Quads

Question 2

Sciatic

Answer 2

L5-S3

biceps fem

Question 3

Tibial

Answer 3

L4-S1

semis, popliteus

Question 4

Obturator

Answer 4

L3-L4

adductors, pectineus, gracilis

Question 5

Superior gluteal

Answer 5

L4-S1

iliacus, TFL, glut med/min

Question 6

Inferior gluteal

Answer 6

L5-S1

glut max

Question 7

Piriformis

Answer 7

S2 nerve/nerve root

Question 8

Psoas major/minor

Answer 8

femoral and L1

L1-L4 nerve roots

Question 9

Gemellus

Answer 9

Superior (L5-S2)

Inferior (L4-S1)

Question 10

Obturator muscles

Answer 10

Internus (L5-S2)

Externus (L3-L4, obturator nerve)

Question 11

Teres Ligament

Answer 11

intrinsic stabilizer

resists hip FABER

Question 12

Iliofemoral ligament

Answer 12

resists ext, ER

Question 13

Ischiofemoral ligament

Answer 13

resists abd w/ hip flex/IR

Question 14

Pubfemoral ligament

Answer 14

resists hyperabd and ER

Question 15

Hip OA Clusters

Answer 15

1 - hip pain, IR < 15 , flex < 115

2 - painful IR, age > 50, AM stiff > 60 min

Question 16

Hip OA CPR

Answer 16

IR < 25
squatting aggravates
flex ROM = lat hip pain
SCOUR or groin pain
pain with ext

Question 17

Labral Repair

Answer 17

1-2 weeks painfree ROM
limit flex 4 weeks
WBAT
no running 12 weeks

Question 18

Debridement

Answer 18

1-2 weeks painfree ROM
limit flex 4 weeks
progress as tol (no time dependent restrictions)

Question 19

Osteoplasty

Answer 19

1-2 weeks painfree ROM
limit flex 4 weeks
initially 20 lb PWB, WBAT @ 4-6 weeks
progress as tol @ 6 weeks

Question 20

Capsular Modification

Answer 20

1-2 weeks painfree ROM
WBAT
limit ER and ext 4 weeks
no running 12 weeks

Question 21

Microfracture

Answer 21

1-2 weeks painfree ROM
limit flex 4 weeks
initially 20 lbs PWB, WBAT @ 4-6 weeks
no running 12-16 weeks

Question 22

Angle of Inclination

Answer 22

angle between neck of femur and shaft

normal 125, > 140 coxa valga, < 120 coxa vara

Question 23

Angle of Torsion

Answer 23

ankle of fem neck and transverse axis of fem condyles
12-15 normal
anteversion - inc angle, toe in
retroversion - dec, toe out

Question 24

Thomas Test

Answer 24

tight hip flexors

Question 25

FABER

Answer 25

SIJ, ant hip pain

Question 26

Renne's Test

Answer 26

TFL pain

Question 27

Nobel's Test

Answer 27

TFL dysfxn

Question 28

Ely's Test

Answer 28

tight rec fem

Question 29

Log roll

Answer 29

intra-articular pathology

Question 30

FADIR

Answer 30

hip impingement, FAI

Question 31

Dial Test

Answer 31

ant lax

Question 32

Pace's and Freiberg's Sign

Answer 32

piriformis syndrome

Question 33

Craig's Test

Answer 33

hip anteversion

Question 34

Percussion Test

Answer 34

LE fx

Question 35

C-sign

Answer 35

pain around hip into groin

Question 36

Quad Contusion (CET)

Answer 36

C - direct blow to upper thigh E - pain, loss of function initially, bruising T - RICE, ROM avoid heat, massage, and US to prevent myositis ossificans

Question 37

Heterotrophic Ossification (Myositis Ossificans) (CEIT)

Answer 37

C - severe blow or repetitive blows; follows a hematoma (acute inflammation following hemorrhage that may become calcified) E - pain, muscle weakness, tissue tension I - X-rays 2-6 weeks after injury T - conservative, surgery after 1 year

Question 38

Femoral Fx (CEIT)

Answer 38

C - significant trauma E - difficulty standing/walking, pain, hip may ER/slight abd (makes it short) I - X-ray T - immediately immob, open or closed reduced, rehab is low (4 mo) fx across epip have highest incidence of AVN

Question 39

Femoral Stress Fx (CEIT)

Answer 39

C - most often in endurance athletes, overuse E - several weeks of gradually increasing pain, pain in groin/ant thigh - may refer to knee, difficulty WBing w/ time I - A/P X-ray may or may not show, bone scan T - rest usually 2-5 mo, conservative tx

Question 40

Quad Strain (CET)

Answer 40

C - sudden, forceful contraction of hip/knee into flex, usually with hip ext E - acute pain, restricted ROM, antalgic gait T - RICE, conservative tx, avoid overstretching

Question 41

HS Strain (CET)

Answer 41

C - change in direction/speed, during terminal swing E - hemorrhage, bruise, pain, antalgic gait T - RICE, conservative tx, avoid overstretching

Question 42

Adductor Strain (CET)

Answer 42

C - running, jumping, twisting esp w/ hip ER E - may not notice pain until end of activity, pain, weakness, antalgic gait T - RICE, conservative tx, avoid overstretching

Question 43

Hip Dislocation (CET)

Answer 43

C - traumatic force along femur usually with knee bent, mostly post E - thigh - FADIR, palpation - tender, possible swelling, may feel femur post to acet T - immediate medical attention for reduction, immob, use of AD can lead to AVN

Question 44

SCFE (CEIT)

Answer 44

C - adolescent boys most common, tall and thin or obese E - groin pain, limited FABIR, walk w/ limp (sometimes see ER of foot or appearance of short limb) I - frog leg view, Kline's line T - NWBing, corrective surgery if unsuccessful

Question 45

LCP Disease (CEIT)

Answer 45

C - AVN of fem head, 4-10 yo, boys common E - groin pain, referral to knee, limping, comes on gradually w/o MOI I - A/P, frog leg; MRI best T - rest and/or immob; avoid WBing

Question 46

Snapping Hip (CET)

Answer 46

C - excessive repetitive movement, ITB snapping over greater troch or iliopsoas over iliopectineal eminence E - iliopsoas "clunk heard across room"; ITB "seen across room"; feeling of instability T - anti-inflammatories, address mobility restrictions, hip stability exercises

Question 47

Labral Tear (CET)

Answer 47

C - forced hip ER while in ext, repetitive motions, degeneration E - pain, clicking, clunking, locking T - conservative, > 4 wks - possible debridement or repair

Question 48

Hip Pointer (CET)

Answer 48

C - iliac crest contusion, blow to iliac crest E - pain, bruise, difficulty rotating trunk T - RICE, referred to X-ray, protection of area

Question 49

Pelvic Stress Fx/Osteitis Pubis (OP) (CEIT)

Answer 49

C - history of overuse, repetitive stress causes if chronic inflammation E - insidious onset, pain at pub symp, feels better NWBing I - A/P or frog, bone scan T - rest, anti-inflammatories, gradual return to exercises

Question 50

Athletic Publagia (CET)

Answer 50

C - repetitive stress from kicking, twisting, cutting; shear forces from forceful hip abd/hypertext E - dull/widespread pain in groin, pain inc w/ resisted hip flex, IR and abdominal contraction, radiates to inner thigh T - conservative tx, cortisone injection, surgery

Question 51

Hip Replacement

Answer 51

Precautions ant - avoid ER/ext, no prone lying post/lat - no flex > 90, IR, add past midline WBing - usually WBAT w/ AD, sometimes given knee immob