Hip Ultrasound

Question 1

Origin of gluteal muscles

Answer 1

posterior surface of ileum,

Question 2

GLuteus minimus inserti

Answer 2

anterior facet of greater trochanter

Question 3

glut medius insertion

Answer 3

supero posterior facets

Question 4

glut max insertion

Answer 4

posterior femur, gluteal tuberosity below the trochanters and Iliotibial tract

Question 5

sartorius origin

Answer 5

ASIS

Question 6

Rectus femoris origin

Answer 6

AIIS

Question 7

semimembranosus tendon and conjoint tendon orientation

Answer 7

semimembranosus tendon is anterior to conjoined tendon…. semimem origin is anterolateral to conjoint tendon

Question 8

Hesselbach triangle landmark

Answer 8

apex laterallly - inferior epigastric vessels , inguinal ligament inferiorly, medial border is rectus abdominis

Question 9

sportsman hernia pathological part

Answer 9

common aponeurosis

Question 10

Spigelian hernia area

Answer 10

between rectus abdominis and lateral abdominal musculature , Lateral margin of rectus abdominis

Question 11

Origin of indirect head of rectus femoris

Answer 11

laterally at the superior acetabular ridge

Question 12

which rectus femoris head becomes a central aponeurosis

Answer 12

indirect head.

Question 13

muscle superficial to the femoral artery

Answer 13

sartorius

Question 14

order of appearance of adductor muscles

Answer 14

AL AB AM a

Question 15

Saphenous nerve location

Answer 15

deep to sarorius and superficial to gracilis

Question 16

what comprises triangle of sciatic nerve

Answer 16

semimembranosus medial, sciatic lateral are the base… apex is the conjoined tendon of BF and ST

Question 17

Between which muscles can you find the obturator nerve?

Answer 17

adductor muscles

Question 18

Gracilis muscle orientation relative to adductors?

Answer 18

superficial and more medial to adductors

Question 19

Differentiate ortolani from Barlows

Answer 19

barlow- dislocate using adduction and posteriorly directed force, Ortolani - relocation using abduction and anteriorly directed force?

Question 20

Name landmarks for DDH scan and typical appearance

Answer 20

egg on spoon, Ilium, acetabulum= alpha angle. should be >60. ilium and labrum angle = beta angle should be <55 degrees

Question 21

Criteria for joint distention/effusion in kids and adults in hip

Answer 21

2mm A-P separation - pedia Adult= 7mm distention. or 1mm asymmetry between contralateral

Question 22

What hip position improves visualziation of hip effusion

Answer 22

leg extension and abduction

Question 23

What happens with a large body habitus to echogenicity of fluid

Answer 23

can cause anechoic fluid to appear ARTIFICALLY Hypoechoic or ISOechoic

Question 24

Causes of synovial hypertrophy

Answer 24

Infection, inflammatory arthritis, PVNS,osteochondromatosis ( with hyperechoic calcifications)

Question 25

Differentiate labral degeneration from tear

Answer 25

degeneration - diffuse hypoechogenicity, tear-defined hypoechoic or anechoic cleft

Question 26

Dynamic evaluation fo femoroacetabular impingement and tx?

Answer 26

hip flexion and internal rotation- direct contact between labral tear and cortical irregularity– osteoplasty

Question 27

Is the hypoechogenicity superior to a arthroplaty prosthesis normal?

Answer 27

yes

Question 28

What is a thigh splint?

Answer 28

adductor insertion avulsion syndrome from chronic repetitive stress injury, WOF periostitis or possible stress fracture?

Question 29

Where is the insertion of the adductor longus

Answer 29

posteromedial femur

Question 30

Differentiate benign enlargement lymph node from malignant

Answer 30

benign- maintained oval shape, hyperechoic hilum. Malignant- ROUND, absence or narrowed hilum, thickening of cortex

Question 31

Role of US in sarcoma?

Answer 31

to monitor for recurrence.

Question 32

Benign differentials of a palpable mass

Answer 32

pseudohypertrophy of TFL, chronic retracted tenon or muscle tear

Question 33

If unstable hips when to do US exam?

Answer 33

younger than 2 weeks

Question 34

If stable hips when to do US

Answer 34

4-6 weeks if there is stable click

Question 35

if normal PE, but with risk factors when to scan

Answer 35

4-6 weeks

Question 36

Angulation criteria for DDH

Answer 36

Alpha- <60 Beta >77