Hip

Question 1

FADIR Test
-sensitivity, specificity, and interpretation

Answer 1

compared to diagnostic injections
Sensitivity = 78%
Specificity = 10%

compared to MRA
Sensitivity = 75%
Specificity = 43%

-passively puts pt’s hip into position that engages femoral head/neck junction in the acetabulum

-good screening test. since specificity is low, positive result doesn’t necessarily get “ruled in or confirmed.” however, if negative, then the likelihood of FAI is much lower

Question 2

Pelvic complex differences
male vs female

Answer 2

Females
-greater pelvic width:height ratio
-wider pubic arch >90 degrees
-uniformly conical inlet(oval)

Males
-taller, narrower, more compact
-narrower pubic arch < 90 degrees
-heart shaped inlet

Question 3

What type of cartilage covers femoral head?

Answer 3

hyaline cartilage
-everywhere except central point(the fovea)

Question 4

What attaches at fovea of femoral head?

Answer 4

ligamentum teres

Question 5

What is the angle of inclination?

Norms for adults?

Answer 5

Angle created by femoral neck and proximal femur in frontal plane

120-125 degrees in adults

Question 6

What angle of inclination results in significant coxa valga/coxa vara?

Answer 6

> 135 degrees coxa valga

<120 degrees coxa vara

Question 7

Normal value range of LCEA(lateral center edge angle)

Answer 7

25-39 degrees

> 40 overcoverage, leading to pincer FAI

<25 degrees may represent hip dysplasia

Question 8

3 extra-articular ligaments of hip

Answer 8

iliofemoral(Y-ligament)
pubofemoral
ischiofemoral

Question 9

Primary and Secondary hip flexors

Answer 9

primary: iliopsoas and rectus femorsis

secondary: TFL, sartorius, pectineus, adductor longus

Question 10

Primary and Secondary hip extensors

Answer 10

primary: glute max and hamstrings

secondary: glute medius and adductor magnus

Question 11

Primary and Secondary hip abductors

Answer 11

Primary: glute medius and glute minimus

secondary: TFL, glute max, piriformis, sartorius

Question 12

Primary and secondary hip adductors

Answer 12

Primary: adductor longus/brevis/magnus, gracilis, pectineus

Question 13

Primary and secondary hip external rotators

Answer 13

primary: glute max
+ 6 subgluteal muscles (piriformis, obturator externus, obturator internus, gemellus superior, gemellus inferis, quadratus femoris)

secondary: post. fibers of glute med, glute min, sartorius, long head of biceps femoris

Question 14

Primary hip internal rotators

Answer 14

primary: none

muscles that contribute: ant. fibers of glute med and glute min, TFL, adductor longus, adductor brevis, pectineus

Question 15

Loose packed position of hip joint

Answer 15

30* flexion
30* abduction
slight ER

Question 16

Close packed position of hip joint

Answer 16

max hip extension + IR + slight abduction

Question 17

Early and late findings of avascular necrosis(AVN) of the hip

Answer 17

Early: minimal changes in ROM
Late: decreased ROM and pain w/ WB

Question 18

Screening/history considerations for avascular necrosis(AVN) of the hip

Answer 18

hx of corticosteroid useis the most common cause of atraumatic AVN
-patients commonly in 30s-50s
-history of hip pain > 6 weeks

referral for imaging if for persistent hip pain in the absence of trauma