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MSK III P3 Fall > 8] Adv. Hip Diagnosis And Treatment > Flashcards

8] Adv. Hip Diagnosis And Treatment Flashcards

1
Q

What’s more common in men

A

Leg calve perthes disease

SCFE

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2
Q

What’s more common in women

A

Hip dislocation

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3
Q

Congenital dysplasia of the hip cause

A

Unknown

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4
Q

Increased incidence of congenital dysplasia

A

First born females, breech

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5
Q

Sign for Cong dysplasia

A

+ ortoloni’s/Barlow

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6
Q

What is + ortoloni/Barlow

A

Hip is ADD then depressed/dislocated then ABD and you hear a clunk

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7
Q

Treatment for congenital dysplasia 1st 4-6 months

A

Pavlik harness

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8
Q

Treatment if more than 6 months

A

Closed reduction

Spica cast

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9
Q

Treatment is more than 1 year

A

Open reduction

Cast

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10
Q

Characteristics of congenital dysplasia of hip

A 
Less femoral head coverage
Decreased surface area
Coxa valgus (more than 125 deg)
Femoral anterversion
Associated with labral tears and early OA
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11
Q

Patho of LCP disease

A

Osteonecrosis of femoral head

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12
Q

Who does LCP happen to and which side?

A

3-10 year old boys and usually uni

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13
Q

LCP clinical findings

A 
Restricted in IR stiff
Spasm of ADD, limiting ABD
atrophy 
Short
Leg length discrepancy 
“Frog leg”
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14
Q

Treatment for LCP

A

Early stage: abduction braces

Later: surgery

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15
Q

SCFE patho

A

Displacement of epiphysis off femoral head

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16
Q

Who does SCFE happen to

A

Pre-pubescent overweighted

Or tall, thing athletic boys

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17
Q

What’s usually the only Sx fo SCFE

A

Medial knee pain

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18
Q

May include a history of trauma or abnormal/excessive exertion

A

SCFE

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19
Q

Clinical findings of SCFE

A 
Decreased IR and flex
Weak IR
Rolls into ER when supine
Antalgic gait
\+ trendelenburg
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20
Q

Treatment for SCFE

A

Pinning
PWB
Amb with AD for 4-6 weeks or until callus

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21
Q

Labral tears often occur inw hat direction

A

Anterior or anterosuperior

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22
Q

MOI for labral tears

A

Trauma: ER with hyperext

Receptive microtrauma: pivoting and twisting

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23
Q

Flexion, ABD, ER followed by ext, ADD, IR

A

Anterior labrum

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24
Q

Usually no pain in FABER

A

Anterior labrum

25
Q

Passive flexion, posterior load

A

Posterior labrum

26
Q

Symptoms fo labral tears

A

Shard deep pain
Click lock catch
Unstable, gives way
Pain in anterior groin region

27
Q

Testing for labral tears

A

No gold standard but MRA is good

28
Q

Anatomy of labrum

A

Inner 2/3 avascular

Only outer 1/3 has potential to heal

29
Q

Surgery for labral tears

A

Arthroscopic removal

Debridement

30
Q

Treatment for labral tears

A

Pain free ROM and strength

Impingement type treatments : mobs and traction

31
Q

Define FAI

A

Impingement b/w femoral neck and lateral acetabulum

32
Q

FAI results in

A

Chondral lesions, labral tears and progressive OA

33
Q

Non spherical femoral head or abnormalities at head neck junction

34
Q

Femoral head neck forced into contact with acetabular rim

35
Q

CAM more common in

A

Young active males

36
Q

Abrasion of cartilage, avulsion of labrum

37
Q

What’s more common: CAM or pincer

38
Q

Over coverage of the femoral head by an abnormally deep or retroverted acetabulum

39
Q

Results in labral injury with less cartilage involvement

40
Q

What’s pincer more common in

A

Middle aged active women

41
Q

Deep acetabulum, with over coverage of neck and posterior inferior sublux

42
Q

Abnormality at neck forced into rim with flexion

43
Q

Reduced ROM for impingement

A

Reduced IR, flex, ADD

44
Q

With hip repairs, how long do you wait until strengthening

45
Q

PWB for 10-14 days

Avoid excessive flex and ABD

A

Labral repair

46
Q

Clinical milestone for labral repair

A

Full PROM at 2 weeks

47
Q

Soft tissue release precaution

A

Guided by pain

Avoid stressing and leg lifts for 4 weeks

48
Q

Soft tissue repair precaution

A

TTWB x 6 weeks

Abd brace

49
Q

Important clinical milestones for sof tissue repair etc

A

6 week strengthening starts

Return to running when bilateral hip strength is good

50
Q

Anterior capsule modification precaution

A

Avoid forceful ER and ext

51
Q

Posterior capsule modification precaution

A

Avoid forceful IR and flexion

52
Q

Milestone for capsular mod

A

Full PROM at 4-6 weeks

53
Q

Non spherical portion of femoral head removed

A

Osteoplasty

54
Q

Precaution of osteoplasty

A

PWB 4-6 weeks
Avoid too much flex/abd/IR
Caution with SLR b/c of hip flex tendinitis

55
Q

Milestone for osteoplasty

A

2 week full PROM

56
Q

For medium sized, full thickness lesions of hip joint

Used to reach blood supply of subchondral bone

A

Microfracture

57
Q

Precaution for microfracture

A

PWB 4-8 weeks
Avoid flex/abd
Caution with SLR b/c of compressive forces

58
Q

Clinical milestone for microfracture

A

2 weeks full PROM

59
Q

Return to sport for combined procedures which is the most stringent time frame

A

10-32 weeks

MSK III P3 Fall (19 decks)

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