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MSK II > Exam 1 - Pelvis and hip 1 > Flashcards

Exam 1 - Pelvis and hip 1 Flashcards

1
Q

describe the sacroiliac joint

A

synovial, non axial

very stable joint with irregular articular surfaces

fibrous capsule reinforced by ligaments in multiple directions

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2
Q

describe the pubic symphysis

A

midline of body
rigth and left pubic ones joined with fibrocartilage disc and ligs
amphiarthrodial joint

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3
Q

what is an amphiarthrodial joint

A

not synovial joint
more stable

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4
Q

what are the attachments of the superior pubic ligament

what is its function

A

attaches the pubic tubercles on each side

strengthens the joint superiorly and anteriorly

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5
Q

what are the attachments of the inferior pubic ligaments

what is its function

A

attaches between the 2 inferior pubic rami

strengthen the joint inferiorly

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6
Q

what is the function of the SI joint

A

designed for stability and has very little mobility

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7
Q

what is the incidence of SI joint dysfunction

A

20% during pregnancy
13% not pregnant with LBP

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8
Q

what are the risk factors for SI joint dysfunction

A

laxity and hormonal changes
during pregnancy - previous LBP/pelvic trauma
none located if not pregnant

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9
Q

what is the etilogy of SI joint dysfunction

A

peri-partum

immature skeletons d/t lack of bony irregularity and congruency

trauma

autoimmune diseases (AS)

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10
Q

what are the symptoms of SI joint dysfunction

A

localized to SIJ
gluteal region and lateral hip
possibly pubic symphysis P!
often like hypermobility/instability

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11
Q

why is SI joint dysfunction symptoms often like hypermobility/instability symptoms

A

too much movement in the SI joint

joint gets loosened and gets off position and gets stuck again

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12
Q

what are the signs of SI joint dysfunction

A

A/PROM: no consistent pattern with just SI dysfunction with

RST: impaired local mm, weak anti-gravity hip mm

ST: >/= 3 (+) of SI provocation tests

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13
Q

what is the evidence for palpation for position for SI joint dysfunction

A

poor studies

considered a special test

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14
Q

t/f
movements in the SIJ are so minute that external determination by manual methods is virtually impossible

A

true

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15
Q

what motion test for SIJ is most useful but is still considered unreliable

A

march or gillet test

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16
Q

t/f
research consensus that motion and palpation SIJ tests are unreliable and invalid

A

true

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17
Q

what special test would you predict to be (+) for SIJ dysfunction

A

ASLR (+) for impaired local mm

18
Q

t/f
imaging is diagnostic for SIJ dysfunction

A

false
imaging is not diagnostic

19
Q

what is the gold standard for diagnosing SIJ dysfunction

A

SI block

20
Q

what is the PT rx for SIJ dysfunction

A

POLICED

STM/muscle energy/acupuncture for P!/ muscle guarding

pelvic belt

JM

MET

education

21
Q

what is the outcome for manipulation of SIJ dysfunction

A

improved symptoms and clinical test findings

did not alter positions per RSA imaging

likely a positive soft tissue and muscle influence per manipulation

22
Q

what is the focus of MET for SIJ dysfunction

A

primary focus is stabilization

local mm and lumbar hypermobility/instability MET

23
Q

what is the focus of pt education for SIJ dysfunction

A

reduce fear

early mobilization without provocation

reassurance of good prognosis

24
Q

what is the MD rx for SIJ dysfunction

A

intra-articular SIJ injections for AS, not recommended without AS

P!/anti-inflammatory meds - mixed short-term benefit

no evidence for prolotherapy or fusion

25
Q

what is the prognosis of SIJ dysfunction

A

rapidly declines during first 3 months after pregnancy

“serious P!” during pregnancy left 21% with symptoms 2 years later

26
Q

what is femoral acetabular impingement

A

abnormal hip joint morphology or bony shape and arrangement

symptomatic contact between proximal femur and acetabulum

27
Q

what is the prevalence of femoral acetabular impingement

A

males > females
higher with vigorous or end range activities (dance)

28
Q

what are the risk factors for femoral acetabular impingement

A

genetics and gender: abnormal bony morphology, higher risk for sibling

vigorous loading in athletics
use of excessive motion
pediatric hip conditions
abnormal hip/pelvis kinematics

29
Q

describe the abnormal hip/pelvis kinematics that can lead to femoral acetabular impingement

A

anterior pelvic tilt

limited posterior tilt that may also limit the coupled hip ER

excessive hip adduction

limited hip IR but is more likely d/t bony abutment than capsular tightness

30
Q

what is the etiology of femoral acetabular impingement

A

largely unknown

more often: abnormal hip mechanics, vigorous athletic loading, combo

less often: slipped capital femoral epiphysis, femoral neck fx/malunion, legg-calve-perthes disease

31
Q

describe the cam femoral acetabular impingement

A

less spherical femoral head

head contacts anterosuperior acetabulum/12:00

more common in males

37% presence in general population without P!

55% presence in athletes without P!

32
Q

describe the pincer femoral acetabular impingement

A

deeper acetabulum or anterior osteophyte

neck primarily contact anterior but may also contact posterior labrum (countercoup phenomenon)

most common in middle-aged athletic females

33
Q

what type of femoral acetabular impingement is most common

A

both cam and pincer

34
Q

what structures are involved with femoral acetabular impingement

A

with/out age-related changes/labral tears

labrum

35
Q

t/f
articular cartilage damage and labral damage are very common with femoral acetabular impingement

A

true
83% with articular cartilage damage
93% with labral damage

36
Q

the labrum is primarily made up of what type of collagen

A

type 1 collagen

37
Q

up to __% of labrum changes are insidious or gradual

A

75%

38
Q

what patients should be considered with mechanical groin pain without alternative radiological diagnosis related to labrum tears

A

active individuals

39
Q

_% of athletes with groin pain have labrum tears related to femoral acetabular impingement

A

20%

40
Q

labral tears related to femoral acetabular impingement affect __% of pts with hip and groin pain

A

55%

MSK II (5 decks)

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