DD Of Hip Flashcards
What is the degrees of Coxa Vara?
<125
What is the degrees of coxa valga?
“L” for longer leg
>125
For reference what is the normal degree of the femoral neck?
125
What is the presentation of Coxa Valga?
-Longer leg on side of valga
-Genu forum common
-Malleoli, fibular heads and trochanters are level
-Iliac spines and crests are high
-Associated with increased anteversion
What is the presentation of Coxa Vara?
-Small area of inclination between femoral neck and shaft of femur
-Shorte”R” leg on coxa vara side
-Genu Valium is common
-Malleoli, fibular heads and trochanters are level
-PSIS/ASIS and iliac crests are lower
-Associated with retro version
What is anteversion?
-Torsion of the femoral neck that causes shaft of femur to IR
-Causes a decrease in ER and glutes cannot fire properly
-Lack of proper push-off in gait
-Results in Genu vagus and pes planes
-Short leg on side of version if unilateral
What is retroversion?
-Decrease in torsion of femoral neck
-Causes a decrease in IR
-Long leg on side of version
What is the special test to diagnose version at the femur?
Craig’s test
What is the capsular pattern of the hip?
Flex>ABD>IR
What is osteoporosis?
chronic progressive disease
-Low bone mass, impaired bone quality and decreased bone strength
Types
Primary: age related, negative calcium balance, progressive estrogen deficiency
Secondary: meds (corticosteroids), cigarette, smoking, sedentary, alcoholism
What is the clinical manifestation of osteoporosis?
Loss of height
-Postural changes
-Thoracic kyphosis (back fractures)
-vertebral body- hyperkyphotic posture, lift heavy, increase intrathoracic pressure- cough/sneeze
-Affects hips, ribs, radius and femur
What is the prevention for osteoporosis?
-Peak bone mass at 30, regular physical exercise, calcium, vitamin D
How do you screen for osteoporosis?
-Bone mineral density testing
Z score: norm values same sex and age
T SCORES***
What is a -1 or higher T score?
Normal
What is a -1 to -2.5 T score?
Osteopenia
What is < or = to -2.5?
Osteoporosis
What is the PT intervention for osteoporosis?
Long term commitment to exercise
-Fall prevention, balance exercises
-Reduce anterior translation of cervicothoracic kyphosis
-Stabilize and increase bone mass (closed chain, eccentric, resistive>aerobic)
What is osteomalacia?
Progressive, lack of mineralization of bone, soft bone, w/o loss of bone matrix
What is the clinical manifestation of osteomalacia?
Deficiency in calcium, vitamin D and phosphate
Initially: general ache, fatigue, weight loss, proximal myopathy, sensory polyneuropathy
-increased thoracic kyphosis, heart shaped pelvis, proximal weakness
-Difficulty with transitional movements, rise from chair, climb stairs, bed mobility
What is the treatment for osteomalacia?
Similar to management of osteoporosis
Nutritional: vitamin D and phosphate
What is Paget’s disease?
Progressive adult skeletal system
-Increased bone resorption with unorganized new bone formation
-Normal bone marrow replaced by fibrous tissue- enlarged bone but weak
What are the clinical manifestations of Paget Disease?
MSK: primarily affect axial skeleton, fractures, bone change in size, shape, alignment, pain periosteal irritation- deep, worse at night, fatigue, LH, stiff, thoracic kyphosis, bowing of femur and tibia, bone is soft
-Coxa Vara
-Waddled gait
Neuro: impingement- myelopathy or ischemia, nerve compression syndrome, mental confusion, sensorineural hearing loss
What is the treatment for Pagets Disease?
Mental deterioration which decreases blood flow, fatigue, vertigo
-Screen alkaline phosphate
-exercise is important** avoid running, jumping, forward bending and twisting, orthotics
