2.5.2. Physical Exam - Hip Flashcards
What method is used to isolate pain in the hip joint
log roll internal rotation
possible cause of internal rotation pain for age 0-3 years
septic hip, hip dysplasia, hip fracture
possible cause of internal rotation pain for age 4-10
toxic synovitis, legg-calve-perthes, juvenile rheumatoid arthritis
possible cause of internal rotation pain for age 11-16 years
slipped capital femoral epiphysis, avascular necrosis, GC arthritis
possible cause of internal rotation pain for age 17-39 years
femoral neck stress fracture
possible cause of internal rotation pain for age 40-80+
osteoarthritis of hip
possible cause of internal rotation for age 60-80+
hip fracture
pain from trochanteric bursa region is most likely due to
degenerative process of the gluteal tendons that insert on trochanter
source for most lateral hip pain
trochanteric bursa
Where is trochanteric bursa located
over greater trochanter of hip
On complaint of pain in the trochanteric region, what is done for evaluation
palpate for tenderness
Three regions in the vicinity of the hip that may cause pain
- hip joint
- trochanteric bursa
- long “double jeopardy” muscles around the hip
Double jeopardy muscles are
long joints that span two joints
double jeopardy muscles include
rectus femoris, sartoris, ilotibial band, biceps femoris (long head), semimembranosus semitendinosus, (Ilio) Psoas
site or origin and site of insertion for sartorius
origin - anterior superior iliac spine
insertion - pes anserine
site of origin and site of insertion for rectus femoris
origin - anterior inferior iliac spine
insertion - tibial tuberosity (via patella)
site of origin and site of insertion for biceps femoris (long head)
origin - ischial tuberosity
insertion - fibular head
site of origin and site of insertion for semimembranosus semitendinosus
origin - ischial tuberosity
insertion - medical tibial condyle and pes anserine
site of origin and insertion of (Ilio) Psoas
origin - thoraco-lumbar vertebrae
insertion - lesser tuberosity of femur
Steps of hip inspection while seated or standing still
swelling of soft tissue, ecchymosis, atrophy
Steps of hip inspection while walking
observe gait for: limping, inability to walk, shuffling, hip atrophy
positive for trendelenberg test is
hip atrophy that results in patient’s raised knee collapsing in towards the standing leg
reverse trendelenberg is
hip atrophy that results in knee being pushed out
negative for trendelenberg is
pelvis is level and balance maintained
hip palpation for supine position is done on
anterior superior iliac spine, anterior inferior iliac spine, pubic ramus
hip palpation for lateral position is done on
greater trochanter, iliotibial band
hip palpation for prone position is done on
SI joint, ischial tuberosity, pririformis muscle
hip range of motion supine is done for the following movments
flexion, internal rotation, external rotation, abduction, adduction
hip range of motion prone is done for the following movements
extension
hip strength is done for what movements
hip flexor flexioin, hip internal rotation, hip external rotation
describe neurovascular portion of hip exam
take femoral pulses
name the special tests done for the hip exam
- FABER
2. FADIR (flexioin, adduction, internal rotation) - tests hip joint proper
Leg Calve Perthes
Childhood condition that affects the hip , where the thighbone (femur) and pelvis meet in a ball-and-socket joint
Occurs when blood supply is temporarily interrupted to the ball part (femoral head) of the hip joint. Without sufficient blood flow, the bone begins to die — so it breaks more easily and heals poorly.
