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MSK 2020 > Adult Hip Problems > Flashcards

Adult Hip Problems Flashcards

1
Q

where can hip pain originate from in the adult?

A

groin

can radiate to the knee (obturator nerve supplies both)

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2
Q

how long does a THR last?

A

10-15 years

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3
Q

what is the most common hip replacement materials?

A

metal-on-polyethene

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4
Q

what is the most common direction of a hip dislocation?

A

posterior

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5
Q

what can occur with a hip dislocation?

A

acetabular wall fracture

femur fracture

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6
Q

presentation of hip dislocation

A

flexed
internally rotated
adducted knee

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7
Q

risks in hip dislocation

A

sciatic nerve palsy
AVN of femoral head
OA

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8
Q

management of hip dislocation

A

reduction

stabilisation

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9
Q

risk factors for proximal femur fractures

A

OP
smoking
malnutrition

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10
Q

two types of proximal femur fractures

A
  1. intra-capsular

2. extra-capsular

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11
Q

what does intra-capsular proximal femur fracture risk?

A

AVN

non-union

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12
Q

three types of extra-capsular proximal femur fractures

A
  1. basicervical
  2. intertrochanteric
  3. subtrochanteric
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13
Q

risks in extra-capsular proximal femur fractures

A

non-union

mal-union

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14
Q

diagnosis of proximal femur fracture

A

XR (Shenton’s line)

MRI

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15
Q

management of extracapsular proximal femur fracture

A

intertrochnateric DHS

IM nail

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16
Q

management of intracapsular proximal femur fracture

A

good function= hemiarthroplasty or THR

poor function= hemiarthroplasty

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17
Q

two types of femoroacetabular impingement syndromes (FAI)

A
  1. cam type impingement

2. pincer type impingement

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18
Q

what is cam type impingement?

A

there is a femoral head deformity (head not round)

19
Q

who is cam type impingement more common in?

A

men

20
Q

what is pincer-type impingement

A

acetabular overhang

21
Q

who is pincer-type impingement more common in?

A

females

22
Q

what are complications of FAI?

A

damage to labrum
damage to cartilage
leads to OA

23
Q

presentation of FAI

A

activity related pain in groin (particularly flexion and rotation)
difficulty sitting
C positive sign (grasping hip)
FADIR test positive

24
Q

diagnosis of FAI

A

MRI for visualising labrum

25
Q

management of FAI

A

observe in asymptomatic patients

surgery

26
Q

surgical options in FAI

A

debride labral tears
peri-acetabular osteotomy
THR in OA

27
Q

what is avascular necrosis of the hip?

A

failure of blood supply to the femoral head

28
Q

what is the blood supply to the femoral head?

A

medial femoral circumflex

29
Q

causes of AVN of the hip

A 
idiopathic
alcohol
steroids
hyperlipidaemia
thrombophilia
30
Q

presentation of AVN of the hip

A

insidious onset

pain exacerbated by stairs or impact

31
Q

diagnosis of AVN of the hip

A

XR normal

MRI shows sclerosis/ lytic zones with hanging rope sign

32
Q

management of reversible AVN of the hip

A 
bisphosphonates
core decompression +/- graft
curettage and bone grafting
vascularised fibular bone graft
rotational osteotomy
33
Q

management of irreversible AVN of the hip (collapse)

A

rotational osteotomy

THR

34
Q

what is idiopathic transient osteonecrosis of the hip?

A

blood supply to the hip has been interrupted

35
Q

who gets ITOH?

A

middle-aged men

women in the 3rd trimester

36
Q

presentation of ITOH

A

progressive unilateral groin pain

difficulty bearing weight

37
Q

diagnosis of ITOH

A

radiographs

MRI

38
Q

what does the XR of ITOH show?

A

osteopenia of head and neck
thin cortices
but preserved joint space

39
Q

management of ITOH

A

self-limiting (6-9 months)
analgesia
protected weight bearing

40
Q

what is another name for trochanteric bursitis?

A

gluteal cuff syndrome

41
Q

what is trochanteric bursitis?

A

repetitive trauma of IT band over bursa causes inflammation

42
Q

presentation of trochanteric bursitis

A

pain on lateral hip

pain on palpation of greater trochanter

43
Q

management of trochanteric bursitis

A

analgesia
NSAIDs
physiotherapy
steroid injections

MSK 2020 (35 decks)

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