Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

2 MSK > Adult Hip Problems > Flashcards

Adult Hip Problems Flashcards

1
Q

What is the VITAMIN acronym for what conditions can cause

A 
V-vascular 
I-infective/inflammatory 
T-traumatic 
A-autoimmune 
M-metabolic 
I-iatrogenic/idiopathic 
N-neoplastic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

you can make new hyaline cartilage true/false

A

false

can only make new fibrocartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is femoroacetabular impingement syndrome (FAI)

A

altered morphology of femoral neck and/or acetabular

causes abutment of the femoral neck on the edge of the acetabulum during movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the two types of femoroacetabular impingement syndrome

A

CAM -femoral deformity,

Pincer -acetabular deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

who gets CAM

A

young athletic males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what does a CAM FAI look like

A

asymmetric femoral head with decreased neck:head ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what does a pincer FAI look like

A

acetabular overhang

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

who gets pincer FAIs

A

females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what do FAIs cause

A

damage to labrum and tears
damage to cartilage
osteoarthritis in later life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What do patients with FAI present with

A

actively related pain in groin particularly in flexion and rotation
difficulty sitting
FADIR provocation test positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what do u use to diagnose FAI

A

radiographs
CT
MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Management for CAM FAI

A

arthroscopic scan or open surgery to remove CAM/debride labral tears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Management for pincer FAI

A

peri-acetabular osteotomy/debride labral tears in pincer impingement

arthroplasty in older patients with secondary OA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is avascular necrosis

A

failure of blood supply to the femoral head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pathophysiology of idiopathic avascular necrosis

A

coagulation of intraosseous microcirculation > venous thrombus causing retrograde arterial occlusion> intreaosseous hypertension>decreased blood flow to femoral head>chondral fracture and collapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

pathophysiology of AVN associated with trauma

A

due to injury of femoral head blood supply (medial femoral circumflex)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

risk factors for AVN

A 
males 
35-50
irradiation 
trauma 
hematologic diseases 
dysbaric disorders alcoholism 
steroid use 
most idiopathic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

patient presentation with AVN

A

insidious onset groin pain
exacerbated by stairs or impact
normal examination unless progressed to collapsed

19
Q

how to diagnose AVN

A

radiography (often normal in early disease)

MRI most sensitive/specific

20
Q

stages of AVN

A

either reversible (0,1,2) presubchondral collapse or irreversible stage (3,4,5,6) post subchondral collapse

21
Q

management for reversible AVN

A 
biphosphonates 
core decompression +/- bone graft 
curettage and bone grafting 
vascularised fibular bone graft 
rotational osteotomy
22
Q

treatment for irreversible AVN

A

total hip replacement

23
Q

what is idiopathic transient osteonecrosis of the hip (ITOH)

A

local hyperaemia and impaired venous return with marrow oedema and increased intramedullary pressure

24
Q

how do ITOH patients present

A

progressive groin pain over several weeks
difficulty weight bearing
usually unilateral

25
Q

who gets ITOH

A

males>females

2 groups: middle aged men and pregnant women in 3rd trimester

26
Q

how do u diagnose ITOH

A

elevated ESR
radiographs
MRI (gold standard)
bone scan

27
Q

Management for ITOH

A

self-limiting condition that resolves in 6-9 months
analgesia
protected weight bearing to avoid stress fracture

28
Q

what is trochanteric bursitis

A

repetitive trauma caused by iliotibial band tacking over trochanteric bursa
causes inflammation of the bursa

29
Q

who gets trochanteric bursitis

A

female patients

young runners and older patients

30
Q

how to patients with trochanteric bursitis present

A

pain on the LATERAL aspect of the hip

pain on palpation of the greater trochanter

31
Q

how to diagnose trochanteric bursitis

A

clinical diagnosis (pain when u press on the trochanter)
radiographs usually unremarkable
visible on MRI but not usually needed

32
Q

how to you manage trochanteric bursisity

A 
analgesia 
NSAIDS 
physiotherapy 
steroid injection. 
no proven benefit from surgery
33
Q

what is the endpoint for multiple pathologies in the hip

A

osteoarthritis

34
Q

Who gets osteoarthritis

A

females>males
typically in older age
genetic element
pre-existing hip disease

35
Q

how do osteoarthritis patients present

A 
GROIN pain 
worse on activity 
pain at night 
start up pain 
stiff on testing range of movement
36
Q

how should you asses patients with osteoarthritis

A

level of symptoms and impact on quality of life
medical comorbidities
social history
would the patient like surgery

37
Q

how do you diagnose osteoarthritis

A

with radiographs

L- loss of joint space
O-osteocytes
S-sclerosis
S-subchondral cysts

38
Q

management of osteoarthritis

A 
analgesia 
weight loss 
walking aids 
physio 
steroid injections 
total hip arthroplasty
39
Q

things to think about in surgical planning for total hip arthroplasty

A

centre of rotation (high or low)
leg length discrepancy
offset (distance between centre of the femoral head and the greater trochanter)
canal width

40
Q

risks for total arthroplasty

A

scar, bleeding, neuromuscular injury, fracture, clotting, infection, dislocation, length discrepancy, loosening, ongoing symptoms

41
Q

types of prothesis for total arthroplasty

A

cemented
uncemented
hybrid

42
Q

bearing choices for arthroplasty

A

metal on poly
ceramic on poly
ceramic on ceramic

43
Q

what is a hybrid total hip arthroplasty

A

uncemented cup (press fit, biological fixation)

cemented stem (cone in a cone)

used in younger patients

44
Q

what is a cemented total hip arthroplasty

A

cemented cup (mechanical lock) and a cemented stem (cone in a cone)

used in older patients

2 MSK (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions