12: Hip Pain Flashcards
T/F The patient can remain clothed during the hip exam.
False. Impossible to get a good feel and visual of the hip landmarks and correct palpation.
When do you check for hip crepitus?
During abduction and adduction.
Hip pain gets worse with _____.
Hip pain gets worse with activity.
Name the 4 hip bursae.
- Illiopsoas
- Trochanteritic
- Gluteus Medius
- Ischiogluteal
This bursa is typically not inflamed and doesn’t cause bursitis.
Gluteus bursa
Most common location of hip bursitis.
Greater trochanter
This bursitis causes pain in groin with radiation to anterior thigh.
Illiopsoas bursitis
Why is illiopsoas bursitis commonly confused with back pain and how do you differentiate?
- The L1 nerve comes around this area.
- Pressing on bursa will hurt if it’s inflamed. The back won’t hurt.
This bursitis causes pain with radiation to the posterior thigh to the knee.
Ischiogluteal bursitis
Why do you get a standing x-ray for hips?
Gives accurate dimension of joint (space narrowing).
How do you manage hip pain?
- Meds:
- NSAIDS
- Tylenol
- Lidocaine Patches
- Capsaicin Cream
- Non-Pharm:
- Heat
- ROM
- ICE
- Rest
- Low Impact Exercise (water therapy)
- Physical Therapy
When do you do a hip MRI?
If avascular necrosis is suspected
When do you refer to ortho?
If no improvement or pain worsens with conservative treatment of 4-6 weeks.
Loss of blood supply to the bone.
Avascular necrosis
Where is the most common location of hip avascular necrosis?
Femoral head
