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MSK 1 > screening of the hip > Flashcards

screening of the hip Flashcards

1
Q

Suspicious Examination Findings - Symptoms

A

acute hip pain with fever
night sweats
night pain
symptoms unchanged by movement or position
symptoms related to period

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2
Q

Suspicious Examination Findings - potential causes

A

tumor
infection
Septic arthritis
osteomyelitis
endometriosis

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3
Q

Corticosteroid use has been reported in cases of

A

avascular necrosis (AVN) and fracture occurring at the hip joint

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4
Q

AVA direct causes

A

fracture of dislocation
radiation
SCFE
sickle cell disease

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5
Q

AVA indirect causes

A

corticosteroid use
chronic alc
autoimmune disease
smoking history

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6
Q

AVN pathogenesis​ in the hip

A

decrease blood flow to the proximal femur which can lead to structural failure and collapse​

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7
Q

AVN clinical presentation

A

Primary pain distribution: groin > buttock > lateral thigh
Secondary/referred pain: knee > anterior thigh > lower leg

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8
Q

Clinical Testing for AVN

A

Lack of tests with high sensitivity

Tests with high specificity
<15 degrees hip extension (0.92)
< 60 degrees hip ER (0.73)
Pain with IR (0.86)

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9
Q

what is Breach birth

A

feet first position for birth

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10
Q

Breach birth issues

A

high association with dysplastic hips

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11
Q

Childhood Disorders for the hip

A

Developmental Dysplasia of the Hip
Legg Calve Perthes Disease
Slipped Capital Epiphysis

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12
Q

Legg Calve Perthes Disease

A

a childhood condition that occurs when the ​blood supply to femoral head of the hip joint is temporarily interrupted and the bone begins to die

the compromised bone may deform

4-10

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13
Q

Slipped Capital Epiphysis

A

occurs when there is a slippage of the proximal epi on the meta
treatment is often conservative

8- 15

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14
Q

hip dysplasia in younger adults

A

is often due to residue childhood and teenaged onset dysplasia

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15
Q

what we are looking for in a Pelvic Screen – History

A

Bowel issues
Bladder-related changes
Pregnancy and birth history.
Psychosocial and mood disorder history
Fear-avoidance characteristics

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16
Q

Fear-avoidance characteristics

A

avoidance of movements or activities based on the fear of increased pain or re-injury.

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17
Q

what is included in the Screening of the Lumbosacral Spine

A

Pelvic landmark palpation
Lumbar AROM Testing
Sensory
Motor exam
Special Tests

  • Determine if spine is primary or contributing factor
18
Q

Screening of the Lumbosacral Spine

A

Prone Instability Test
Thigh Thrust Test

19
Q

Prone Instability Test

A

Presence of lumbar instability

SN = 72%, SP = 58%

20
Q

Thigh Thrust Test

A

Sacroiliac joint irritability

Cluster of findings more useful for SIJ dysfunction

21
Q

Lumbosacral Spine - Neural Tension Tests

A

SLR
active slump
prone knee flexion

22
Q

Stress Fractures in the hip description

A

Mechanically induced fracture of the proximal femur or pelvis

Repetitive overload that overcomes normal structural properties
Example: overtraining, rapid volume increase

Loading that overcomes compromised structural properties
Example: fracture occurring with osteopenia

23
Q

Differential Diagnoses with stress fracture in the hip

A

Acetabular labral tear
Hip flexor strain
Hip adductor strain
Iliopsoas bursitis
Osteochondral lesion
Hip OA

24
Q

Osteochondral lesion

A

lesions are a tear or fracture in the cartilage covering one of the bones in a joint

25
Q

types of stress fractures

A

Compression sided
Tension sided

26
Q

Compression sided stress fracture in the hip

A

Inferior region of femoral neck
Conservative management

27
Q

Tension sided stress fracture in the hip

A

Pulled apart – tension
Superior region of femoral neck
ORIF - surgery

28
Q

Stress Fractures – Clinical Presentation pain

A

Groin & anterior thigh most common
Potential for lateral thigh and more rarely in gluteal region
Potential for medial knee pain
Often reproducible with end-range IR and overpressure (motion more limited in proximal/neck region)
May be reproducible with SLR or MMT for flexion and/or abduction

29
Q

Stress Fractures – Clinical Presentation functional

A

Initially occurs as pain during or after strenuous activity (running)
Progresses to affect lower level activity (walking)
In acute stages, can be painful at rest or at night

30
Q

Clinical Tests for a ​stress fracture

A

Patellar-pubic Percussion Test (femoral neck)
- he has not had luck with this test

31
Q

Patellar-Pubic Percussion Test procedure

A

Patient in supine position
Stethoscope placed over pubic tubercle
Clinician listens through stethoscope as they tap the ipsilateral patella

32
Q

Patellar-Pubic Percussion Test interpretation

A

Lack of sound propagation may indicate fracture

No noise: the fracture is stopping the sound from transmitting

33
Q

Stress fracture​ diagnostic imaging

A

Plain Radiography (AP, frog-lateral)

Bone scan

MRI

34
Q

stress fracture Plain Radiography (AP, frog-lateral)

A

Rule out other conditions (OA, tumor, etc.)
Examine for displacement

35
Q

Stress Fracture Bone scan

A

Demonstrates increased focal uptake of radiotracer at site of fracture (“hot spot”)
May read negative for first 24 hours after occurrence development

36
Q

Stress fracture MRI

A

Ideal in sensitive and specificity
Yields information about surrounding tissue (differential diagnoses)

37
Q

FABER Test Interpretation

A

felx, ABD, ER: joint screen

Normal: equal ROM bilaterally with no symptom reproduction

Abnormal: ask where the pain is
Anterior/Inguinal pain: potential hip pathology
Posterior pain: may indicate potential SI joint dysfunction

38
Q

Scour Test

A

joint screen

Normal: no interruption of motion, no pain
Abnormal: pain/discomfort, grating sensation, crepitis-like sound. This may indicate degenerative changes

39
Q

what is a screen test used for

A

Screening test – not that specific just testing to see if the pain is originating from the hip

40
Q

what is a screen test used for

A

Screening test – not that specific just testing to see if the pain is originating from the hip

MSK 1 (14 decks)

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