4- Hip Problems

Question 1

What can cause buttock pain

Answer 1

Hip pathology
Lumbar spine problems
SI joint problems

Question 2

Which hip pathology often presents purely with knee pain

Answer 2

SUFE

Question 3

What pathology presents with a positive Trendelberg sign or gait

Answer 3

Hip abductor weakness

Can be caused by altered biomechanisms or chronic disease

Question 4

Aside from hip joint pathology, what else can cause groin pain

Answer 4

Hernia - inguinal or femoral
Tendonitis
Pubic symphysis dysfunction
High lumbar disc prolapse - rare

Question 5

For which pathologies might you perform a THA or THR

Answer 5

OA 
RA 
seronegative arthropathy 
AVN 
dysplasia 
Perthes 
SUFE

Question 6

What might make you consider undergoing a THR

Answer 6

Level of pain and disability
If conservative treatments are not working

Have to balance to benefits and risks

Question 7

What conservative methods should you try for hip pain before surgery

Answer 7

analgesia 
physio 
walking aids 
weight reduction 
activity modification

Question 8

What are the potential complications of re-doing a hip replacement

Answer 8

Larger and more complex surgery
Substantial blood loss
2x complication rates
Poorer outcome

Question 9

The hip is a rare site of AVN - true or false

Answer 9

False

One of the most common sites

Question 10

What are the symptoms of hip AVN

Answer 10

Groin pain

Question 11

How does AVN present on X-ray

Answer 11

Early - no change

Later - patchy sclerosis, lytic zone underneath giving hanging rope sign

Question 12

How do you treat AVN in the hip

Answer 12

If detected before collapse then drill holes can be made in femoral neck to relieve pressure
After collapse you need a THR

Question 13

How do you treat trochanteric bursitis

Answer 13

Analgesia
Anti-inflammatory
Physio
Steroid injection