Othropaedic Hip Conditions Flashcards Preview

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Flashcards in Othropaedic Hip Conditions Deck (39)
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1
Q

What 3 bones make up the pelvis?

A

Ischium, ileum, pubis

2
Q

What does the head of the femur articulate with?

A

The acetabulum

3
Q

What muscles attach to the greater trochanter?

A

Abductors and rotators

4
Q

What muscles attach to the lesser trochanter?

A

Psoas

5
Q

What is the labrum?

A

Fibrocartilagious lining of acetabulum

6
Q

What is the purpose of the labrum?

A

Deepen socket,

Adds stability

7
Q

Blood supply of pelvis and femur?

A

Profunda femoris- medial and lateral circumflex arteries,

Ligamentum teres artery

8
Q

How many branches does the medial femoral circumflex artery have?

A

2 branches

9
Q

How many branches does the lateral femoral circumflex artery have?

A

3 branches

10
Q

Difference between a intracapsular and extracapsular fracture?

A

In a intracapsulr fracture the blood supply is disrupted

11
Q

What is osteoarthritis?

A

Degenerative changes of synovial joints,

There is progressive loss of articular cartilage and secondary bony changes

12
Q

What is trochanteric bursitis?

A

Inflammation of the trochanteric bursa

13
Q

Causes of trochanteric bursitis?

A

Trauma,
Overuse (eg athletes)
Abnormal movements (eg distant problem- scoliosis or local problem- OA, total hip replacement)

14
Q

Trochanteric bursitis presentation?

A

Lateral hip pain and tenderness,
Tenderness at greater tuberosity,
Worse pain in active abduction

15
Q

Trochanteric bursitis investigations?

A

Xray,
MRI,
US

16
Q

Trochanteric bursitis treatments?

A
NSAIDs, 
Rest, 
Activity modification,
Physiotherapy,
Corticosteroids injection,
Bursectomy
17
Q

Define avascular necrosis?

A

Death of bone due to loss of blood supply

18
Q

Trauma risk factors of avascular necrosis?

A

Irradiation,
Fracture,
Dislocation,
Iatrogenic

19
Q

Systemic risk factors of avascular necrosis?

A
Idiopathic, 
Hypercoaguable states, 
Steroids, 
Sickle cell disease,
Lymphoma, 
Leukaemia,
Caisson’s disease, 
Alcoholism
20
Q

Idiopathic avascular necrosis pathoanatomic cascade?

A
Coagulation of intraosseous microcirculation, 
Venous thrombosis,
Retrograde arterial occlusion, 
Intraosseous hypertension, 
Reduced blood flow, 
Cell death, 
Chondral fracture and collapse
21
Q

Avascular necrosis symptoms?

A
Insidious onset of groin pain, 
Pain with stairs, walking uphill, impact activities, 
Limp,
Reduced ROM, 
Stiff joint
22
Q

Treatment of avascular necrosis ?

A
Reduce weight bearing, 
NSAIDs, 
Bisphosphonates,
Anticoagulants, 
Physiotherapy,
Core decompression, 
Vascularised graft, 
Rotational osteotomy, 
Total hip replacement
23
Q

What is femoroacetabular impingement?

A

Impingement of femoral neck against anterior edge of acetabulum

24
Q

The 2 categories of femoracetabular impingement?

A

Cam lesion,

Pincer

25
Q

FAI pincer define

A

Abutment of lesion on edge of acetabulum

26
Q

In FAI pincer there is an abnormal acetabulum which can lead to?

A

Anterosuperior acetabular rim overhang,

Acetabular protrusion

27
Q

Femoracetabular impingement presentation?

A

Groin pain,
Groin pain worse with flexion,
Pain with certain manoeuvres

28
Q

Associated injuries with femoroacetabular impingement

A

Labral degeneration and tears,
Cartilage damage and flap tears,
2ndary hip osteoarthritis

29
Q

Expected findings of Femoracetabular impingement on examination

A

Reduced flexion,
Reduced internal rotation,
Positive FADIR test (flexion ADduction Internal Rotation_

30
Q

Investigations of FAI

A

Xray,

MRI

31
Q

FAI non-operative treatment?

A

NSAIDs,
Activity modification,
Physiotherapy

32
Q

Operative treatment of FAI

A

Arthroscopy,
Resection,
Periacetabular osteotomy,
Hip arthroplasty

33
Q

Causes of labral tears?

A
FAI, 
Trauma, 
OA, 
Dysplasia,
Collagen diseases
34
Q

Presentation of labral tears

A

Groin or hip pain,
Snapping sensation,
Jamming or locking

35
Q

Examination findings of labral tear?

A

Positive FABER test (Flexion ABduction External Rotation)

36
Q

What gives a positive FABER test?

A

Labral tear

37
Q

What gives a positive FADIR test?

A

Femoracetabular impingement

38
Q

Investigations of labral tear?

A

Xray,

MRI arthrogram

39
Q

Treatment of labral tear?

A
Activity modification,
NSAIDs, 
Physiotherapy, 
Steroid injection, 
Arthroscopy