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MI1 > The Hip Region > Flashcards

The Hip Region Flashcards

1
Q

In what sports is adductor tendinopathy common?

A

Sports with kicking & rapid direction changes e.g. soccer, AFL, hockey

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2
Q

What is the acute mechanism of injury for labral tears?

A
  • Twisting injury, fall or pedestrian accident

- Acute onset groin pain, through to LS pain

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3
Q

What is the chronic degenerative mechanism of injury for labral tears?

A

Traction pulls the labrum off the acetabulum over a long period

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4
Q

What is the treatment for labral tears?

A
  • Arthroscopic debridement

- Repair of bone fragments

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5
Q

What are labral tears a precursor to?

A

OA

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6
Q

What are the two types of femoroacetabular impingement (FAI)?

A
  • Cam impingement

- Pincer impingement

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7
Q

What are the characteristics of cam impingement?

A
  • Malshaped femoral head
  • Abnormal motion
  • Labral tears & articular degeneration
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8
Q

What are the characteristics of pincer impingement?

A
  • Acetabulum malshaped or femoral head laxity

- Capsulolabral pinching = inflammation = degeneration

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9
Q

What are some of the less common medical causes of hip/groin pain?

A
  • Appendicitis
  • Urinary tract abnormality
  • Prostatitis
  • Gynaecological abnormality
  • Rheumatological disorders e.g. ankylosing spondylitis
  • Tumours e.g. testicular
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10
Q

What area of pain indicates either glut med tendinopathy of greater trochanteric pain syndrome (GTPS)?

A

Over greater trochanter, sacrum, posterior & lateral thigh

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11
Q

What may glut med tendinopathy or GTPS be confused with?

A

Trochanteric bursitis

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12
Q

What are aggravating factors of glut med tendinopathy?

A
  • Sleeping on affected side
  • Descending stairs
  • Sitting for long periods esp with crossed legs
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13
Q

What objective sign is associated with glut med tendinopathy?

A

Positive Trendelenburg sign/gait

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14
Q

What is the treatment for glut med tendinopathy?

A

Strengthening

  • Abduction supine & standing
  • Bridging exercises
  • TA exercises
  • Static quads

Stretching
- Iliopsoas to improve hip extension

Gait retraining

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15
Q

What is osteitis pubis?

A

Inflammation of the pubic bones

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16
Q

What are the XR features of osteitis pubis?

A
  • Subchondral erosion (bone thinning out)

- Pub symphysis joint sclerosis

17
Q

What type of XR view should be used for osteitis pubis?

A

Flamingo (standing on one leg)

18
Q

What people commonly get osteitis pubis?

A
  • Soccer players
  • Runners
  • Post-pregnancy
  • Post pelvic operations
19
Q

What are the signs and symptoms of osteitis pubis?

A
  • Localised pubic pain
  • Tenderness
  • Muscle spasm
  • Limp
  • Muscle stretching increases pain
20
Q

What is the hypothesised relationship between TA & groin pain?

A
  • TA contracts in a feed-forward manner to prevent movement of the pelvic ring
  • Slow contraction in the presence of groin pain can result in movement of the pelvis
21
Q

What are the implications of the relationship between TA & groin pain?

A

Part of treatment needs to include retraining/restoring neuromotor control to TA to improve stabilisation of the pelvic ring

22
Q

What are the NTBM conditions of the hip/groin area?

A
  • Slipped capital femoral epiphysis (SCFE)
  • Legg-calve-perthes disease
  • AVN
  • Stress fracture (NOF, inferior pubic ramus)
23
Q

What is SCFE?

A
  • Posteromedial & inferior slipping of the proximal femoral epiphysis
  • Secondary loss of HF, ER, Abduction
24
Q

What population is affected by SCFE?

A
  • Males > females (2:1)
  • 10-17 years
  • 75% are obese
  • 25% are bilateral
25
Q

What are the clinical features of SCFE?

A
  • Pain (hip, thigh, knee)
  • Muscle spasm
  • Limp
  • Decrease in HF, abd, IR/ER
26
Q

What should you always check when a child presents with knee pain?

A

Always check the hip

27
Q

What is Legg-Calve-Perthes disease?

A
  • Temporary avascular necrosis of femoral head occurring spontaneously in childhood
  • Results in collapsing of femoral head if not treated/unloaded
28
Q

What population is affected by Perthes?

A
  • Males > females (4:1)

- 2-13 years

29
Q

What is the likely aetiology of Perthes?

A
  • Artery of ligamentum trees closes in childhood
  • Femoral neck artery takes over blood supply
  • May happen if femoral neck artery is delayed
30
Q

What are the clinical features of Perthes?

A
  • Groin pain, radiating to knee
  • Painful limp
  • Pain limiting hip ROM
  • Muscle spasm
  • Later, hip stiffness
  • Depends on severity
31
Q

What is the treatment for Perthes?

A
  • Stabilisation of joint for healing (crutches, traction in bed, cast, abduction brace)
  • Surgery
  • Manage pain, inflammation
  • ROM: Gait retraining, physio, aquatics, exercises (abduction, rotation)
32
Q

What stress fractures are associated with hip/groin pain?

A
  • Ischial tuberosity
  • Pubic rami
  • Neck of femur
  • Shaft of femur
  • Sacral body
33
Q

What are the two mechanisms of NOF stress fractures?

A
  • Tension: Superior surface, emergency due to full fracture risk
  • Compression: Inferior surface
34
Q

What are the treatments for NOF stress fractures?

A
  • Tension: Surgery or strict bed rest

Compression: NWB, then increase

MI1 (18 decks)

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