Adult Hip Conditions & Surgery Flashcards
Miss S Gill
what is the pneumonic for surgical sieve?
vitamin
Vascular Infective/inflammatory Traumatic Autoimmune Metabolic Iatrogenic/idiopathic Neoplastic
what is Femoroacetabular impingement syndrome (FAI)?
Altered morphology of femoral neck and/or acetabular
Causes abutment of the femoral neck on the edge of the acetabulum during movement
Usually flexion, adduction and internal rotation
what is a CAM type impingement a deformity of?
femur
Asymmetric femoral head with decreased head:neck ratio
Can be related to previous SUFE
who are CAM inpingements seen in?
young athletic men
Pincer type impingements are deformity of what structure?
acetabulum
seen in females
acetabular overhang
what do CAMs and pincer types FAIs cause?
damage to the labrum and tears
damage to cartilage
osteoarthritis in later life
what is the patient presentation in FAI?
Activity related pain in the groin, particularly in flexion and rotation
Difficulty sitting
C sign positive
FADIR provocation test positive
how would you diagnose FAI?
Radiographs
CT
MRI (better for visualising damage to labrum and bony oedema)
what is the management in FAI?
Observation in asymptomatic patients
surgery
what is avascular necrosis?
Failure of the blood supply to the femoral head
what is the main cause of AVN?
idiopathic
what age and sex is AVN common in?
males
35-50
what are the risk factors for AVN?
trauma irradiation hematologic disease dysbaric disorders alcohol steroid most are idiopathic
what is the patient presentation of AVN?
Insidious onset of groin pain
Examination is usually normal unless disease has advanced to collapse/OA
what is AVN pain exacerbated by?
stairs or impact
how do you diagnose AVN?
radiographs
MRI is best