Adult Hip

Question 1

Issues associated with intraarticular pathology

Answer 1

Osteoarthritis, Osteonecrosis, (Labral tears, Loose Bodies, Synotvitis Septic Arthritis, and Aynovial Chondromatosis)

Question 2

6 components of the PE of the hip

Answer 2

PRLTTF (Pain, ROM, Leg Length, Trendelenburg, Thomas, FABER)

Question 3

Treatment of OA always starts with ______, the most important being ________.

Answer 3

Conservative therapy, losing weight

Question 4

Name the nerve associated with the area of referred pain from the hip: medial thigh, suprapatellar region, buttock

Answer 4

Obturator (most common), femoral, and sciatic

Question 5

Describe acetabular protrusio

Answer 5

head of the femur displaced medially to the ilio-ischial line

Question 6

Name at least 3 complications of hip arthroplasty

Answer 6

Acetabular protrusio, DVT, and Leg Length Discrepancy

Question 7

What to give pt to avoid DVT

Answer 7

Low molecular weight heparin

Question 8

Describe the Log Roll Test and when to use it

Answer 8

If pt can’t bear weight, passively internally and externally “roll” the leg, (+)greater external rotation/pain

Question 9

4 Specific Types of Fractures of the Femoral Neck

Answer 9

Capital, subcapital, transcervical, and basicervical

Question 10

Type II Intracapsular

Answer 10

Complete fracture, non-displaced

Question 11

Type IV Intracapsular

Answer 11

Complete fracture, fully displaced

Question 12

Type I Intracapsular

Answer 12

Incomplete or valgus impacted

Question 13

Type III Intracapsular

Answer 13

Complete fracture, partially displaced

Question 14

How to treat types 1 and 2 intracapsular fractures

Answer 14

In-situ pin (percutaneous screw fixation)

Question 15

How to treat types 3 and 4 intracapsular fractures and why

Answer 15

Hemiarthroplasty, blood supply is compromised

Question 16

3 Types of Extracapsular Hip Fractures

Answer 16

Basicervical, Intertrochanteric and subtrochanteric

Question 17

2 ways to treat extracapsular hip fractures and which is more common and how do they differ anatomically

Answer 17

Dynamic Hip Screw (DHS) and Cephlomedulary Nail (IM); IM is more common and fixation is more medial

Question 18

Crescent Sign

Answer 18

indicative of subchondral collapse; early stage finding that shows there are impending structural changes

Question 19

Treat early stage osteonecrosis with _______; pre-collapse stage.

Answer 19

Biphosphonates

Question 20

Common cause of external snapping

Answer 20

Running on a banked surface

Question 21

Meralgia Paresthetica (what and where)

Answer 21

Entrapment of the lateral femoral cutaneous nerve, at the ASIS between the inguinal ligament and the Sartorius muscle

Question 22

Tenderness and pain on greater trochanter, discomfort when lying on effected side, pain with adduction and internal rotation

Answer 22

3 Signs of Greater Trochanter Bursistis

Question 23

Three ways to treat osteonecrosis:

Answer 23

Structural bone grafts, osteoinductive grafts, and core decompression

Question 24

Difference between external and internal snapping, which is most common

Answer 24

External (most common): Iliotibial band over greater trochanter
Internal: iliopsoas over iliopectineal eminence

Question 25

External snapping is reproduced with:

Internal snapping is reproduced with:

Answer 25

Passive hip flexion from adducted position

Hip going from flexion to extension

Question 26

Objective test for assessing extent of necrosis

Answer 26

Necrosis

Question 27

Posterior Dislocation presents as

Answer 27

flexed at the hip, adducted and internally rotated

Question 28

Anterior dislocation presents as

Answer 28

externally rotated with varying degrees of flexion and abduction