Lower extremity part 1 trigger Flashcards
(44 cards)
if you do the FABER test and there is contralateral pain what is the likely etiology
sacroiliac dysfunction
ipsilateral indicated hip pathology!
if we measure from the anterior iliac crest to the medial malleolus and there is a 5cm difference between both legs is it considered significant?
yes. anything >3cm is significant!
what positive test indicates osteoarthritis or femoral head necrosis
leg roll test (internal and ext rotation of the related lower extremity in supine position)
positive is pain in anterior hip or groin.
Supine/unaffected side, then contralateral hip and knee flexed to 90deg. Stabilize pelvis, apply flexion adduction and internal rotation at knee
what test is this describing and what is a positive test? what does it indicate?
piriformis test.
+ is pain in the butt/leg
indicates piriformis impinging on sciatic nerve
flex hip and knee at 90d. apply posterolateral force through hip as femur rotates. passively adduct and internally rotate hip followed by abduction and external rotation.
what is this and what is a positive test? what does it indicate?
scouring test
pain/grating sound is positive
indicates labral pathology, loose body or internal derangement.
what test indicates impingement of sciatic nerve?
piriformis test
Supine/unaffected side, then contralateral hip and knee flexed to 90deg. Stabilize pelvis, apply flexion adduction and internal rotation at knee
what test indicates labral pathology, loose body or internal derangement.
scouring test
flex hip and knee at 90d. apply posterolateral force through hip as femur rotates. passively adduct and internally rotate hip followed by abduction and external rotation.
pt presents with severe pain in her LLE after a MVA where her knees hit the dashboard. she is unable to move her leg and reports numbness and tingling on the lateral portion of her leg. PE shows left leg is adducted and internally rotated. what diagnostics do you need and what is the tx and dx?
diagnostic: Xray of hip, femur and knee to r/o assocaited injuries.
dx: posterior hip dislocation
tx: allis maneuver w/i 6 hrs and CT hip w/o afterwards.
MOI for this is a hyperextended force against an abducted leg
anterior hip dislocation
could also be anterior force on the posterior femoral head.
shortened, adducted and internally rotated leg
posterior hip dislocation
leg that is abducted, externally rotated and flexed. dx and tx
anterior hip dislocation (this could also be a hip fx i suppose!)
tx: open reduction
what would cause us to want to assess for AVN for 2-3 years after treatment
a hip reduction
pt presents to the office 3 days after a fall during which she hurt her hip. She reports she is now having lateral hip pain what is worse when she rises from a seated position or lying on the affected side. Pt reports sometimes she thinks it gets better when she starts walking, but after about 30 minutes of walking it worsens again. PE shows point tenderness over greater trochanter.
what is dx and tx
dx: greater trochanteric bursitis
tx: NSAIDS, activity modification, ice, short term cane use, stretching.
bursal injections if needed
improves with walking but after 30 min of walking it worsens
greater trochanteric bursitis
Pt presents for her 6 month post hip reduction checkup and reports she began experiencing severe pain approximatly 2 weeks ago for about 3 days. she reports she thinks it is getting better becuase it is now just a dull aching and throbbing pain. She does however report that she is having decreased ROM and increased pain w ROM.
what diagnostics would you get on this patient and what would you see? what is the tx and dx?
Hip Xray - patchy areas of sclerosis and lucency. could also see crescent sign if late enough.
dx: AVN
tx: surgical intervention with core decompression or arthriplasty
severe pain at first then dull aching/throbbing
AVN
Xray shows patchy sclerosis and lutency and possible crescent sign
AVN
crescent sign = subchrondral fracture
what does focal tenderness over knee joint lines suggest
torn meniscus
what does generalized tenderness over knee joint lines suggest
arthritis
+ bulge sign suggests what
knee effusion
+ ballottement sign suggests what
knee effusion
push on patella and then rapidly releasing is what test? what is positive
ballottement test.
+ is rapid rebound indicating increased fluid pressure in knee
place patient in supine position w 30 d knee flexion. displace patella laterally via medial pressure.
what test is this and what is a positive test. what does it indicate
- patellar apprehansion sign
- pos is contraction of quads or apprehension d/t pain
- pos can indicat patellofemoral syndrome, patellar dislocation or subluxation
what test has pt supine with knee fully extended. one hand suprior to the patella and gently pushes patella inferiorly while patient contracts quads.
what is this and what is a positive test?
patellar grind/clarke sign
positive is pain, grinding or clicking.
indicates patellofemoral syndrome/chrondromalacia
