MSK - Hip pain

Question 1

Age for transient synovitis

Answer 1

3-8 years old

Question 2

Age for septic arthritis

Answer 2

Any age

Question 3

Age for Slipped capital femoral epiphysis (SCFE)

Answer 3

Ages 10-16

Question 4

Age for Legg-Calve-Perthes disease (LCPD)

Answer 4

Ages 4-10

Question 5

Ages for developmental dysplasia of the hip (DDH)

Answer 5

Infancy

Question 6

Self limited, idiopathic avascular necrosis of the femoral head that typically affects children ages 4-10

Answer 6

Legg-Calve-Perthes disease

Question 7

A congenital deformation affecting either the femoral head, the acetabulum, or supportive structures around them causing hip instability, subluxation of the femoral head, hip dislocation and/or acetabular dysplasia

Answer 7

Developmental dysplasia of the hip

Question 8

Antalgic gait, restricted range of motion (especially internal rotation and abduction) of the affected hip and pain in the hip, upper leg, and/or knee

Answer 8

Legg-Calve-Perthes disease

Question 9

A condition where the shear forces of the proximal femur are stronger than the epiphyseal growth plate, resulting in superior and anterolateral displacement of the femoral neck

Answer 9

Slipped capital femoral epiphysis

Question 10

Self limited inflammation of the synovium of the hip joint, causing hip pain and a limp most commonly in children ages 3-8. Associated with a viral illness.

Answer 10

Transient synovitis

Question 11

An infection of the bone

Answer 11

Osteomyelitis

Question 12

Most common cause of osteomyelitis

Answer 12

Staphylococcus aureus

Question 13

Osteomyelitis in IV drug users and children is caused by ____ spread

Answer 13

hematogenous

Question 14

A joint infection that causes severe pain, swelling, erythema, warmth and loss of function to the affected joint; may have systemic signs such as fever.

Answer 14

Septic arthritis

Question 15

Lateral hip pain caused by a tendinopathy of the gluteus medius or minimus

Answer 15

Greater trochanteric pain syndrome (previously called trochanteric bursitis)

Question 16

A condition chactaterized by the degeneration of the articular cartilage and underlying bone as a result of chronic wear and tear, usually in the elderly

Answer 16

Osteoarthritis

Question 17

Death of bone tissue due to interruption of blood supply

Answer 17

Avascular necrosis

Question 18

Antalgic gait, pain in the hip or upper leg, sometimes projecting the knee with insidious onset. Exacerbated by internal rotation causing restricted range of movement in a 4-10 year old

Answer 18

Legg-Calve-Perthes disease

Question 19

A limp caused by the effort to avoid pain while walking characterized by a shortened stance phase and increased swing phase of the affected leg.

Answer 19

Antalgic gait

Question 20

Diagnostic test for LCPD

Answer 20

AP and frog leg X-ray

Question 21

Increased lucency of the femoral head, flattening and fragmentation of the femoral head and joint space widening

Answer 21

LCPD

Question 22

Risk factors for SCFE

Answer 22

• obesity
• family history
• endocrine or hormonal factors
• trauma

Question 23

SCFE causes the displacement of the ____

Answer 23

METAPHYSIS is displaced, not the epiphysis

Question 24

dull pain in the medial thigh, knee, groin or hip, limping, restricted range of motion (reduced internal rotation and abduction), patients may hold their hip in passive external rotation

Answer 24

SCFE

Question 25

External rotation and abduction during passive flexion of the affected hip in supine position

Answer 25

Positive Drehmann sign

Question 26

Imaging modality for suspected SCFE

Answer 26

Xray AP view pelvis frog leg lateral views (stable SCFE) cross table lateral views (unstable SCFE)

Question 27

Widening of the epiphyseal growth place, superior and anterolateral displacement of the femoral neck relative to the epiphysis

Answer 27

SCFE

Question 28

Snapping of the iliotibial band or gluteus maximus over the greater trochanter (External) or snapping of the iliopsoas tendon over the iliopectineal eminence (internal) typically seen in young athletes and dancers aged 15-35

Answer 28

Snapping hip syndrome

Question 29

Unilateral groin pain that may radiate to the medial thigh, buttock and/or knee, antalgic gait or refusal to bear weight, limited range of motion, onset of symptoms over 3-5 days, low grade fever.

Answer 29

Transiet synovitis

Question 30

A complication of sickle cell disease in 7-15 year olds caused my infarction of the trabecular bone from RBC sickling and vaso-occlusion, commonly in the femoral head leading to subacute hip pain without systemic symptoms.

Answer 30

Avascular osteonecrosis (of the femoral head)