HIP Flashcards
Osteoarthritis in the hip usually presents in patients older than
65
What would be confirmed on an X-Ray
- Osteoarthritis
- decrease in ROM
- pain with weight bearing
- severe pain all the time even @ noc
Is a condition where the blood supply to the femoral head is disrupted causing bone deathe
Avascular necrosis
Avascular necrosis occurs @ what age?
20 - 30 yo
Avascular necrosis is more dominant in males or females?
Male
How does avascular necrosis present?
like osteoarthritis with groin pain or a labral tear
Acute hip pain time line
3-4 weeks
Subacute hip pain
12 weeks
Chronic hip pain anywhere from
3 months
Mechanism of injury: falling onto the side of the hip can lead to
trochanteric bursitis
MOInjury: falling & landing on knee could jar the hip in the
acetabulum, possibly causing a labral tear
What structures, issues are involved regarding the hip?
orsteoarthritis, labral tears, greater trochanteric pain syndrome and gluteal strains
Pain involving the hip joint often presents
in the groin and length front or medial side of the thigh
From where can pain be referred to lateral or posterior portion of the hip?
Lumbar spine
Hip involving muscular or ligament pathology can refer pain to the
low back and/or knee
When do you know it is trochanteric bursitis?
Point tenderness presenting over the greater trochanter
Involved hip joint refers pain to
groin, along anterior or medial thigh
Hip muscle/ligament involved refers pain to
low back and/or knee
Lumbar spine involved refers pain to
lateral or posterior portion of the hip
What type of pain is necessary to examine?
Somatic, Neurogenic?
Identify the location of the pain through testing whether the pain is
nerve root or trigger point related
Also determine through palpation whether _________ are irritated
bursa
For the pain quality, deep pain in the groin, sometimes pinching sensation tends to be ________ related
hip joint pathology
For the pain quality, soreness, ache, dull pain, sometimes sharp in the posterior glue can be either _________ or _______ related, test to determine which.
muscle or nerve root
What is very important to determine regarding low back and/or hip dysfunction?
leg length and innominate position
innominate
having no name
innominate position
ilium, ischium, pubis on one side
Normal degrees of PSIS to ASIS tilt (or PSIS is how many degrees higher than ASIS)
Normally 7-15 degrees
or looking at an average of 11 degrees plus/minus 4
What 3 types of pelvic disparities are there?
1 - anterior pelvic tilt
2 - posterior pelvic tilt
3 - Hip Hike (lateral pelvic tilt)
The type of anterior or posterior tilt can be either
bilateral or unilateral
How can you determine the tilt degrees of the anterior/posterior tilt?
Palpating the ASISes w/PT standing
How can you determine the tilt degrees of the HIP HIKE?
Palpating the ILIUMs w/PT standing
3 types of Leg Length disparities
1 - Functional
2 - Structural
3 - Environmental
Soft tissue change causing Leg Length Disparities are called:
Functional changes
Boney changes causing Leg Length Disparities are called:
Structural changes
Running surface, shoes causing Leg Length Disparities are called:
Environmental changes
What is the third most common cause of running injuries ?
Leg length asymmetries …
In runners how much of a percentile of injuries are do to Leg Length Asymmetries?
60 -90 %
What can movements or views can help tell if muscle shortness on one side is contributing to hip problem?
view feet, internal or external rotation of hip
Which movement at the hip joint is the first restriction to occur in hip disease
INTERNAL rotation
LOWER CROSS SYNDROME is
static
What muscles are lengthened and weak in Lower Cross Syndrome?
Abdominals, Gluteals
What muscles are tight in Lower Cross Syndrome?
Iliopsoas
Erector spinae
Hamstrings
PSIS and ASIS are located how in Lower Cross Syndrome?
PSIS extra high
ASIS extra low
LOWER EXTREMITY IMPAIRMENT SYNDROME is
functional
How is the Lower Extremity Impairment Syndrome defined?
shortened (XS) • Erector Spinae • Iliopsoas • Rectus Femoris lengthened (DEF) • Abdominals • Gluten • Hamstings
Palpate for
tenderness trigger points muscle spasm ah shi points boney abnormalities
How should you palpate the Greater Trochanter?
From multiple angles
What landmarks are important to be palpated assessing the HIP?
- PSIS
- Iliac Crest
- SI joint
- Inguinal Ligament
- Gluteal Musculature
