The Hip pathologies

Question 1

Age and gender for OA?

Answer 1

> 45 years
double in prevalence in females
insidious

Question 2

What are the symptoms/body chart of OA?

Answer 2

Deep ache in groin/thigh/knee/leg
Morning stiffness >30-60 minutes
Bony swelling, joint deformity, joint warmth/tenderness, muscle wasting
medial rotation <15

Question 3

What is Femoroacetabular impingement syndrome?

Answer 3

abnormal contact between the acetabulum and femoral head-neck junction
younger adults, 25-50 years
structural deformity

Question 4

What is a PINCER impingement?

Answer 4

extra bone extends over the acetabulum. The labrum can be crushed under the prominent rim of the acetabulum

Question 5

What is a CAM impingement?

Answer 5

extra bone on the edge of the femoral head grinds the cartilage inside the acetabulum

Question 6

What are the symptoms/body chart of impingement syndrome?

Answer 6

Anterolateral hip pain, dull/aching

- sign of the C, gripping lateral hip just above trochanter, between abducted thumb and index finger

Question 7

Aggravating factors of OA?

Answer 7

weight bearing and prolonged rest

Question 8

Aggravating factors of Anterior impingement?

Answer 8

prolonged sitting forwards or rising from chair

Question 9

What is Acetabular labral tears?

Answer 9

3 types 
1. radial fibrillated labral tear 
2. peripheral longitudinal tear 
3. radial flap labral tear 
varied across age groups

Question 10

Causes of Labral tears?

Answer 10

structural deformity
major trauma
repetitive sporting activities

Question 11

What are the symptoms/body chart of Labral tears?

Answer 11

anterior tears: groin/thigh
posterior tears: buttock
clicking and locking of the hip and pain over joint line during flexion

Question 12

Aggravating factors of Labral tears?

Answer 12

dancing
swimming
squatting/pivoting

Question 13

Age and gender for Greater trochanteric pain syndrome?

Answer 13

more common in women 40-60

caused by inflammation, physical trauma in muscles, tendons, fascia or bursae

Question 14

Causes of GTPS?

Answer 14

insidious
trauma: direct impact to hip
Repetitive sporting activities

Question 15

What is the body chart/symptoms of GTPS?

Answer 15

Deep ache: Groin, lateral thigh radiating to leg
‘snapping’ laterally

assessment- pain on palpation of greater trochanter and lateral hip pain with a FABER

Question 16

Aggravating factors of GTPS?

Answer 16

running
ascending stairs
sitting cross legged

Question 17

Age and MOI of Iliotibial band friction syndrome?

Answer 17

Varied across age groups

Repetitive sporting activities

Question 18

What are the symptoms/body chart for Iliotibial band friction?

Answer 18

Tenderness over lateral epicondyle of the femur 1-2cm above the lateral joint line
‘Sharp’ burning pain upon testing
Produced lateral knee pain in cyclists, dancers and Long-distance runners

Question 19

Aggravating factors of Iliotibial band friction?

Answer 19

Running and Cycling

Flexion/ extension of knee can reproduce symptoms

Question 20

What is Piriformis syndrome?

Answer 20

Piriformis may become inflamed, hypertrophied, in spasm/contracture
Subsequent sciatic nerve entrapment may occur

Question 21

Signs and symptoms of Piriformis syndrome?

Answer 21

pain and/or paraesthesia in buttock, hip and/or posterior thigh
Sciatic nerve signs
tenderness to palpate piriformis
Restriction in medial rotation of the hip