Disorders of the hip Flashcards
What is osteoarthritis?
Degenerative disorder arising from the breakdown of articular hyaline cartilage
- non-inflammatory
- no systemic involvement
What are the two classifications of osteoarthritis and whats the difference?
1) Primary = unknown cause
2) Secondary = known cause
What are the risk factors for primary osteoarthritis?
- Age
- Female
- Ethnicity (african-american, american-indian)
- Genetics
- Nutrition
What are examples of causes for secondary osteoarthritis?
- Obesity
- Trauma
- Infection
- Inflammatory arthritis
- Metabolic disorders affecting joint e.g. gout
- Haematological disorders
What are the general symptoms for osteoarthritis (any joint)?
- Deep aching pain
- Reduced range of motion
- Stiffness
Describe the pathological process of osteoarthritis
1) Damage to hyaline cartilage
2) Swelling of hyaline cartilage (by increased proteoglycan synthesis by chondrocytes) = attempt to repair
3) Cartilage soften and lose elasticity
4) Erosion and loss of joint space
5) Eburnation
What is eburnation?
Vascular invasion and increased cellularity of subchondral bone in response to erosion and loss of joint space
-thickening and hardening
What are the 4 cardinal signs of osteoarthritis on an X-ray?
- Reduced joint space
- Subchondral sclerosis (reprsents eburnation)
- Bone cysts
- Osteophytes
What are the treatments for osteoarthritis of the hip?
- Weight reduction (if overweight) by activity modification, walking stick or frame and muscle strengthening exercises
- Analgesia (pain killers e.g. paracetamol)
- Anti-inflammatories
- Steroid injections
- Total hip replacement
Define what a fractured neck of femur is (#NOF)
A fracture of the proximal femur, up to 5cm below the lesser trochanter
How are #NOF classified?
- Intracapsular
- Extracapsular (further subdivided into intertrochanteric or subtrochanteric)
Why are intracapsular #NOF more dangerous?
High risk of avascular necrosis
-disrupt retinacular arteries
What are the common mechanisms for #NOFs?
Intracapsular = elderly with minor fall Extracapsular = young and middle aged with significant traumatic force e.g. road traffic collision
How does a patient with #NOF present?
- Reduced mobility
- Pain in hip, groin and/or knee
- Leg is shortened, abducted and externally (laterally) rotated
What is a dislocation of the hip?
Head of the femur is fully displaced out of acetabulum
