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MSK > Common hip conditions > Flashcards

Common hip conditions Flashcards

1
Q

What blood vessel mainly supplies the femoral head

A

The medial femoral circumflex artery

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2
Q

What is osteoarthritis

A

Joint destruction - degenerative change of synovial joints

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3
Q

How is osteoarthritis characterised

A

Worsening pain and stiffness of the specific joint

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4
Q

What is bursitis

A

inflammation of the bursa

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5
Q

What are symptoms of trochanteric bursitis

A

Pain when lying on side and when walking

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6
Q

Which gender is trochanteric bursitis more common in

A

Females

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7
Q

What are the causes of trochanteric bursitis

A

Trauma
Athletes - over use
Abnormal movements
Muscle wasting
osteoarthritis
hip replacements

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8
Q

What is the presentation of trochanteric bursitis

A

tenderness at the greater tuberosity

May have scars from surgery or muscle waisting

Pain when actively abducting hip

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9
Q

What investigations are done for trochanteric bursitis

A

X-ray
MRI
Ultrasound - can be therapeutic to guide steroid injection

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10
Q

What is the treatment of trochanteric bursitis

A

NSAIDs
Rest
physiotherapy
Injection of corticosteroids
Surgical: bursectomy

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11
Q

What is avascular necrosis

A

Death of bone due to loss of blood supplu

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12
Q

Who does avascular necrosis of the hip more commonly occur in

A

Males
35-50

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13
Q

Is avascular necrosis usually bilateral or unilateral

A

80% bilateral

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14
Q

What are the risk factors of avascular necrosis

A

Commonest risk factor is alcoholism

steroids are a common cause

Trauma - fraction or dislocation

Systemic - steroids, alcoholism, hypercoaguable states , haematological - sickle cell

Caisson’s disease is also common – people who worked as divers or as tunnelers

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15
Q

What are the symptoms of avascular necrosis

A

Insidious onset of groin pain (gradual onset)

Pain with stairs and walking uphill

A limp

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16
Q

What is the presentation of avascular necrosis on examination

A

Normally normal

Similar to early arthritis with a stiff joint with reduced range of motion

17
Q

What is the investigation of for avascular necrosis

A

MRI is most effective

X-ray

18
Q

How is avascular necrosis treated

A

Reduce weight bearing
NSAIDs
Bisphosphonates in early avascular necrosis
Anticoagulants
Physiotherapy - maintain movement

Surgical treatment -
core decompression - drilling holes into femur head to relieve pressure
Hip replacement
rotational osteotomy

19
Q

What is the function of bisphosphonates

A

Inhibit the activity of osteoclasts

20
Q

What is impingement

A

Two surfaces hitting each other

21
Q

What is femoroacetabular impingement

A

The edge of the acetabulum impinging on the femoral neck

22
Q

What does femoroacetabulae impingement cause

A

Hip issues in younger issues and secondary osteoarthritis

23
Q

What is a cam lesion

A

Femoroacetabular impingement at the femoral neck mainly

24
Q

Who is a cam lesion more common in

A

Young athletic males

25
Q

What is a pincer lesion

A

Acetabulum based impingement

26
Q

Who is pincer lesion more common in

A

Active females

27
Q

What are femoroacetabular inmipingement associated with

A

Labral damage
cartilage damage
secondary hip osteoarthritis

28
Q

How does femoroacetabular impingement present

A

Groin pain - worse in flexion
Pain with certain movements like squatting

29
Q

What are the tests for cam and pincer lesions in femoroacetabular impingement

A

FADIR test -
F - flexion
AD- adduction
I - internal
R - rotatii

30
Q

What is the treatment of femoroacetabular impingement

A

NSAIDs and physiotherapy

Surgical -
arthroscopy - shave down defect - deal with labral issues and resect cartilage flaps

open surgery :
resection
periacetabular osteotomy
Hip arthroplasty - replacement of articular cartilage

31
Q

What are causes of labral tears

A

Femoroacetabuular imingement
trauma
osteoarthritis
dysplasia

32
Q

What are symptoms of labral tears

A

groin or hip pain
snapping sensation
jamming or locking

33
Q

What is seen on examination of labral tears

A

Can be normal
positive FABER test
F- flex
AB - abduction
E - external
R - rotation

34
Q

What onvestigations are done for labral tears

A

MRI arthrogram - MRI with contrast injection into joint

35
Q

What is the treatment for labral tears

A

NSAIDs
Physiotherapy
steroid injection

Surgical:
Arthroscopy - repair or resection

MSK (36 decks)

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