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MSK > disorders of the hip > Flashcards

disorders of the hip Flashcards

1
Q

hip joint pain causes

A

osteoarthritis, osteonecrosis, inflammatory conditions (RA, SA), fractures of femur or pelvis, dislocation

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2
Q

hip joint pain location

A

groin, anterior proximal thigh, buttock, lateral thigh

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3
Q

s/s of hip joint

A

decreased ROM, limp, inability to bear weight, inability to perform straight leg raise

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4
Q

soft tissue pain around hip on lateral aspect of proximal thigh can be ..

A

trochanteric bursitis, lateral cutaneous nerve impingement, snapping hip syndrome

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5
Q

pelvic differences between females and males

A

female pelvic is more oval or round, smaller compared to male

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6
Q

other causes of hip and groin pain

A

SI joint pain, malignancy, infections, hernias, GI disorder

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7
Q

hip dislocation etiology

A

when femoral head is displaced from acetabulum
high energy trauma

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8
Q

hip dislocation presentation

A

severe pain, unable to move lower extremity

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9
Q

hip dislocation PE

A

posterior dislocation - shortened affected limb, hip fixed in flexion, adduction and internal rotation, sciatic nerve palsy
anterior - hips fixed in mild flexion, abduction and external rotation

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10
Q

hip dislocation secondary survey

A

femur or acetabulum fracture
abrasions
knee ligament injury

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11
Q

hip dislocation imaging

A

AP of pelvis, AP and lateral views of the femur including knee

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12
Q

hip dislocation treatment

A

reduction ASAP

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13
Q

hip dislocation adverse outcome

A

avascular necrosis

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14
Q

fracture of the femoral shaft etiology

A

usually caused by high energy trauma

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15
Q

fracture of the femoral shaft presentation

A

severe pain in the thigh, deformity, unable to move or bear weight

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16
Q

fracture of the femoral shaft imaging

A

AP and lateral of femur (looking for femur fx)
hip, knee, and pelvis xray

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17
Q

fracture of the femoral shaft treatment

A

traction, surgery

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18
Q

fracture of the femoral shaft adverse outcomes

A

fat embolism, multisystem organ failure, complications of open fractures

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19
Q

traumatic fracture of the pelvis etiology

A

fx of pelvic ring or acetabulum
always two fracturs

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20
Q

traumatic fracture of the pelvis presentation

A

may be associated with massive blood loss
signs of hypovolemic shock
groin pain, lateral hip or buttock area

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21
Q

traumatic fracture of the pelvis PE

A

push on ASIS with patient supine

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22
Q

traumatic fracture of the pelvis treatment

A

surgery

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23
Q

pelvic fracture treatment

A

can be treated non-surgically

24
Q

fracture of the proximal femur

A

common in elderly individuals
generally involve femoral neck, intertrochanteric region

25
Q

femur fracture risk factors

A

advanced age, smoking, white women, dizziness, alcoholism, osteoporosis

26
Q

femur fracture presentation

A

history of fall, pain in groin, inability to bear weight.
thigh pain, knee pain!!

27
Q

femur fracture PE

A

externally rotated, abducted
limb shortened if displaced
pain with log roll test
unable to straight leg raise

28
Q

femur fracture imaging

A

AP of pelvis, cross table lateral view of hip.
avoid frog lateral d/t pain

29
Q

femur fracture treatment

A

ortho referral, surgery within 48 hrs d/t high risk for thromboembolic events, evaluate for osteopororis

30
Q

osteonecrosis

A

death of varying amounts of bone in femoral head
steroids? (prednisone)

31
Q

stages of osteonecrosis

A

cellular, fragment collapse, surface collapse, arthritis development

32
Q

osteonecrosis presentation

A

dull ache or throbbing pain in groin/thigh, hip or buttock
limited ROM, progressive limp

33
Q

osteonecrosis PE

A

pain with attempted straight leg raise and ROM of hip

34
Q

osteonecrosis imaging

A

AP of pelvis, frog lateral view, MRI if needed

35
Q

osteonecrosis ddx

A

fracture of femoral neck, lumbar disc disease, muscle sprain, osteoarthritis, SA

36
Q

osteonecrosis treatment

A

surgical intervention

37
Q

hip impingement aka femoral acetabular impingement etiology

A

occurs when ossesous deformities occur on acetabular rim, femoral head-neck junction or both

38
Q

femoral acetabular impingement presentation

A

C sign
worse with prolonged sitting, stairs, getting into/out of car
pain over greater trochanter

39
Q

femoral acetabular impingement PE

A

pain and limited internal rotation
decreased hip flexion and internal rotation
positive impingement sign

40
Q

femoral acetabular impingement treatment

A

acetaminophen, NSAIDs, activity modification, deep tissue massage
for refractory cases - surgery

41
Q

lateral femoral cutaneous nerve syndrome (meralgia paresthetica) etiology

A

compression or entrapment of the lateral femoral cutaneous nerve
tight clothing/belt, trauma, obesity

42
Q

lateral femoral cutaneous nerve syndrome presentation

A

pain, burning, hypoesthesia

43
Q

lateral femoral cutaneous nerve syndrome treatment

A

remove cause, pain medication if needed

44
Q

snapping hip etiology

A

snapping or popping sensation due to tendons around the hip moving over bony prominences
IT band snapping over greater trochanter most common

45
Q

snapping hip presentation

A

iliotibial - occurs with walking or rotation of hip. localized to trochanteric area
iliopsoas - felt in groin as hip extends (rising from chair)

46
Q

snapping hip treatment

A

reassurance, avoid proactive maneuvers, exercise to stretch
if pain - NSAIDs

47
Q

hip and thigh strains etiology

A

injuries to the muscle-tendon units around the joints

48
Q

hip and thigh strains presentation

A

pain over injured muscles that is exacerbated when they are continuously used

49
Q

stress fractures of the femoral neck (hip) etiology

A

result from dynamic, continuing process
occurs most commonly in athletes, advanced age, military

50
Q

stress fractures of the femoral neck presentation

A

groin and thigh pain associated with weight bearing
usually subsides after cessation of activity
pain with extreme ROM of hip

51
Q

stress fractures of the femoral neck imaging

A

may be missed on plain imaging
bone scans can detect stress factors
maybe MRI

52
Q

stress fractures of the femoral neck treatment

A

cessation of activity
non-weight bearing
surgical emergency if young patient

53
Q

trochanteric bursitis etiology

A

lateral hip pain.
inflammation and hypertrophy of greater trochanteric bursa

54
Q

trochanteric bursitis presentation

A

pain and tenderness over the greater trochanter area
may radiate to knee or ankle or buttock
worse when first rising from sitting
unable to lie on affected side

55
Q

trochanteric bursitis treatment

A

injection of local anesthetic and corticosteroids, NSAIDs, activity mod, IT band stretching, cane usage

MSK (20 decks)

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