Disorders of the hip Flashcards
Osteoarthritis
Non-inflam breakdown of articular hyaline cartilage resulting in joint pain accompanied by functional limitation and reduced QOL
Risk factors of primary osteoarthritis
- Age
- Female
- Genetics
- Nutrition?
Causes of secondary osteoarthritis
- Obesity
- Trauma
- Malalignment (congenital)
- Infection
- Inflam arthritis
- Metabolic disorders eg. gout
- Haematological disorders
- Diabetes
4 signs of OA on X-ray
- Reduced joint space
- Subcondral sclerosis
- Bone cysts
- Osteophytes
Osteoarthritis of the hip
- Joint symptoms
- Pain in hip, glut and groin region radiates to knee
- Mechanical pain
- Crepitus
- Reduced mobility
Treatment of OA
- Weight reduction + activity modification
- Pain relief and NSAIDs
- Steroid injections can reduce swelling
- Hyaluronic acid injection increase lubrication and promote cartilage repair?
Cure of OA
Total hip replacement
Fractures of femoral neck
Fracture of proximal femur up to 5cm below the lesser trochanter.
- Intracapsular
- Extracapsular - intertrochanteric and subtrochanteric
Clinical significance of intracapsular #NOF
Disrupt branch of medial femoral circumflex artery = high risk of avascular necrosis
How intracapsular #NOF happen
Elderly in minor fall, treated by replacement of femoral head or total hip replacement
How extra capsular #NOF happen
Young and middle age in significant trauma
Symptoms + signs of #NOF
- Reduced mobility
- Sudden inability to bear weight on limb
- Pain may be in hip, groin and knee
- Fracture displaced = affected leg shortened, abducted and externally rotated
Traumatic hip dislocation
Head of femur fully displaced out of acetabulum - congenital or traumatic (knee on dashboard in road traffic collision)
Presentation of hip dislocation
90% posterior
Affected limb shortened, flexed, adducted and internally rotated
Anterior dislocation
External rotation and adduction w slight flexion
