External Hip Pathologies

Question 1

What is an internal snapping hip?

Answer 1

Iliopsoas tendon is moving over the iliopectineal eminence or the iliacus muscle

Question 2

What can manifest from an internal snapping hip?

Answer 2

iliopectineal bursitis

Question 3

What are the s/s of internal snapping hips?

Answer 3

• painful/audible/palpable snapping when the hip is moved from FLX/ABD/ER to EXT and neutral
• TTP over ANTERIOR hip
• limping

can be asymptomatic (can have snapping but no pain)

Question 4

What can relieve pain if a patient has an internal snapping hip?

Answer 4

Hip FLX and ER

Question 5

What is external snapping hip?

Answer 5

iliotibial band or gluteus maximus moves over the greater trochanter

Cause: overuse/repetition/trauma

Question 6

External snapping hip is more common in _____ in their ______ years.

Answer 6

more common in girls in their late teens and early 20s (due to their growth spurt)

Question 7

What external hip pathology has the highest prevalence in athletes that perform repetitive hip FLX?

Answer 7

snapping hip

Question 8

What are the s/s of external snapping hip?

Answer 8

pain over the greater trochanter at the attachment of the hip ABD or along the IT band

Question 9

External snapping hip is reproduced with hip (AROM/PROM) into ___ and ____.

Answer 9

Hip AROM into hip FLX and ROT

Question 10

(true/false) External snapping hip has no snapping with PROM.

Answer 10

true

Question 11

Where can deep pressure be applied to the hip to stop the snapping sensation of external snapping hip?

Answer 11

Deep pressure to the posterior greater trochanter

Question 12

What femoral head/neck Fx has the highest risk with the worse prognosis?

Answer 12

Superior side Fx

Question 13

What causes fatigue stress Fx?

Answer 13

repetitive and abnormally high loading from WB activities (runners, athletes, military)

Question 14

What causes insufficiency stress Fx?

Answer 14

Poor bone density

Question 15

What population are insufficiency stress fractures most commonly seen in?

Answer 15

elderly, post-menopausal women

Question 16

What influences the prognosis of a femoral head/neck Fx?

Answer 16

Location of the Fx

Question 17

What are the s/s of femoral head/neck Fx?

Answer 17

• deep pain to the anterior, medial, or lateral thigh
• pain with WB activities
• night pain (if fracture progresses)
• pain with hip ER/IR
• pain with resisted ER

(+) patellar-pubic percussion test

Question 18

What is the most common symptom of femoral head/neck stress Fx?

Answer 18

pain with resisted ER

Question 19

What two hip pathologies are common in children?

Answer 19

slipped capital femoral epiphysis (SCaFE)

legg calve perthes

Question 20

Definition: femoral head posteriorly slipping off of the femoral neck

Answer 20

slipped capital femoral epiphysis

Question 21

What is the most common disorder affecting adolescent hips?

Answer 21

slipped capital femoral epiphysis

Question 22

What population is commonly seen with SCaFE?

Answer 22

overweight males, 11-13 y/o

–> often during rapid growth spurts

Question 23

What are s/s of SCaFE?

Answer 23

• pain in anterior groin, thigh, or knee
• GRADUAL onset
• pain with walking, running, WB
• gait has a limp or has the LE positioned in ER
• painful hip ROM

Question 24

definition: disruption of blood supply to the femoral head leading to avascular necrosis

Answer 24

legg calve perthes disease (“little children’s problem”

Question 25

What population does legg calve perthes disease most commonly effect?

Answer 25

boys, 4-10 y/o

Question 26

What is the most common symptom of legg calve perthes disease?

Answer 26

limping

–> some children may describe pain in the groin, anterior thigh, or knee