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Sports Medicine (Final Exam) > Pelvis Hip and Thigh Injuries > Flashcards

Pelvis Hip and Thigh Injuries Flashcards

1
Q

what is a leg-calve-perthes

A

AVN of the femoral head

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2
Q

MOI of leg-calve perthes

A

unknown etiology

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3
Q

history of leg-calve-perthes

A

-usually children ages 4-10 with 4:1 males, 20% bio -pain in groin, thigh or knee -insidious onset usually with a limp

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4
Q

what will be found on physical examination of a leg-calve-perthes

A
  • no internal or external hip rotation
  • pain with motion
  • hip or knee/thigh pain
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5
Q

what type of gait will be seen with a leg-calve-perthes

A

Trendelenburg gait

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6
Q

radiographs of a leg-calve-perthes will show what

A

-increased radio density (sclerotic changes)

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7
Q

what is the treatment of leg-calves perthes

A
  • conservative with rest, crutches, PT
  • containment of head in acetabulum with casting or bracing
  • surgery in severe cases of Ped. Ortho
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8
Q

what is the history of a slipped capital femoral epiphysis (SCFE)

A
  • children usually male ages 10-14, rapidly growing -bilateral 50% of the time
  • insidious onset with hip, groin, thigh, knee pain
  • obese male, delayed development usually
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9
Q

what will be found on physical exam of a slipped capital femoral epiphysis

A
  • spasms, synovitis, reduced ROM
  • observe external rotation with hip flexion
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10
Q

what is the treatment for a slipped capital femoral epiphysis

A

surgical reduction

  • major difference btwn LCP
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11
Q

what history is common with Trochanteric Bursitis

A
  • tight IT band
  • runner with trochanteric pain during flexion and extension (increased with coxa varum)
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12
Q

what is the MOI of Trochanteric Bursitis

A
  • commonly the result of overuse rather than direct trauma
  • pain may radiate to the groin or in approximately 1/3 of patients, pain will radiate into the lateral thigh
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13
Q

what is evident upon PE of trochanteric bursitis

A
  • while lying down on the unaffected side, leg extended have pt flex hip
  • produces an aching pain over the lateral hip that is exacerbated by activity such as prolonged standing lying on the ipsilateral side, stair climbing, or running
  • pain is reproduced w/ external rotation and abduction and by resisted abduction
  • ITB tightness may be present
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14
Q

what test is positive in a trochanteric bursitis

A

ober test

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15
Q

what is the ober test

A
  • the patient lies in the decubitus position with the affected leg up
  • the examiner lowers the knee to the table to assess for IT band tightness
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16
Q

what is the treatment of Trochanteric Bursitis

A
  • modify activity: do not flex/extend hip and less varus tension
  • IT band stretching
  • steroid injection
  • evaluate for other causes if conservative tx fails
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17
Q

Paulska states that bursitis is due to

A

repetitive activity or acute trauma, may affect the trochanteric, ischial or iliopectineal bursar

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18
Q

who does avulsion hip fractures occur in

A

-rapidly growing adolescent males -mm. stronger than growth plates

19
Q

injury to the iliac crest is what type of fracture

A

avulsion fracture

20
Q

what muscles originate off the ASIS

A

TFL

Sartorius

21
Q

what muscles originate off the AIIS

A

rectus femoris

22
Q

what type of contracture can cause an avulsion fracture

A

ballistic loading with eccentric contracture

23
Q

what is the cause/diagnosis of avulsion hip fracture

A

muscle strain or contusion

24
Q

what is the treatment of avulsion hip fractures

A
  • PRICE -crutch ambulation
  • stretch and strengthening after 2 weeks
  • return to activity with return of strength and function
25
Q

what is a common history found in avulsion fractures (ASIS)

A
  • a sudden contraction of the sartorius
  • forced contraction with knee flexed and hip extended (eg. before a kick-falls)
  • anterior lateral thigh parasthesias
26
Q

what will be found during PE of Avulsion Hip Fracture at ASIS

A
  • P.O.P @ ASIS
  • localized tenderness and/or swelling is noted and flexion and abduction of the tigh provokes symptoms
  • pain against hip flexion with knee extension
27
Q

what do radiographs reveal for an avulsion hip fracture (ASIS)

A
  • displacement of the ASIS is note
  • marked displacement is rare
28
Q

what history is common for an avulsion hip fracture at the AIIS

A

-forced contraction “kicking” -groin pain

29
Q

what is found on PE for an avulsion fracture at the AIIS

A

-P.O.P -pain against hip flexion with knee extension

30
Q

what is the MOI of an avulsion hip fractures at the AIIS

A
  • occurs after contraction of the rectus femoris with vigorous kicking
  • examination reveals local tenderness and swelling in the region of the AIIS and exacerbation with active flexion
31
Q

ischial tuberosity fracture is common in what type of athlete

A

hurdlers

32
Q

what history is common in an ischial tuberosity fracture

A

-stron hamstring contraction with hip flexed and knee extended

*suddent pain in buttocks “can’t go on”

-common in hurdlers

33
Q

the ischial apophysis is the origin of the

A

-hamstrings and adductor magnus

34
Q

what is the MOI for an ischial tuberosity fracture

A
  • is a vigorous hamstring contraction with the hip flexed and the knee extended
  • in runners, this injury occurs most often in hurdlers
35
Q

what is found upon PE on an ischial tuberosity fracture

A
  • hip flexion with the knee extended will reproduce symptoms; thus, the presentation and examination are similar to a hamstring strain in an adult
  • P.O.P
  • pain with straight leg raise and resisted knee flexion
36
Q

what history is present with hamstring strain

A
  • occurs often in baseball and track -tight, poor warm-up, fatigue
  • fast contraction, extension of the knee
37
Q

what is found upon PE of a hamstring strain

A
  • pain with resisted knee flexion (use of hams against resistance)
  • P.O.P muscle belly
  • visible or palpable knot
38
Q

what is the treatment for hamstring strain

A
  • NSAIDS
  • PRICE
  • weight bearing so tolerated (bc can’t sit so they use crutch)
  • E-stim
  • stretching bilateral
  • pool running
  • strengthening
  • isokinetic
39
Q

what history is present with piriformis syndrome

A
  • Benchwarmer’s syndrome
  • trauma, prolong sitting, overuse
  • dull ache in mid-buttocks -pain walking up stairs
  • pain from either swelling or compression sciatic
40
Q

piriformis syndrome may have what type of gait

A

Trendelenburg gait

41
Q

what is a major cause of iliopsoas tendonitis/bursitis

A

-acute trauma and overuse resulting from repetitive hip flexion

42
Q

what history is present in iliopsoas tendonitis/bursitis

A
  • groin pain worse with activity
  • “snapping” with hip flexion
43
Q

what is found on PE of iliopsoas tendonitis/bursitis

A
  • pain with resisted hip flexion
  • P.O.P over pubic ramus lateral to neuro vascular bundle (NVB)
44
Q

what is the treatment for iliopsoas tendonitis/bursitis

A
  • steroids - injection, oral steroids
  • NSAIDs: naproxin, Naprosin, anaprox, ibuprofen, Lodine -modify activities -strengthening and stretching exersisess
  • E stim: galvanics, NNMS, MMES

Sports Medicine (Final Exam) (3 decks)

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