Hip

Question 1

hip - Deformities + alignment

Answer 1

Spine - lordosis (FFD - OA) + scoliosis
Pelvis - alignment
Knee - flexion as compensation for FFD
Foot - external rotation (#NOF)

Question 2

hip - Scars

Answer 2

arthroscopy

hip replacement

Question 3

hip - wasting

Answer 3

quadriceps

gluteal

Question 4

hip - swelling

Answer 4

effusion
inflammation
bursitis

Question 5

hip - skin changes

Answer 5

erythema

bruising

Question 6

apparent leg length shortening

Answer 6

FFD causing pelvic tilting

OA causing fixed adduction

Question 7

true leg shortening

Answer 7

joint/bone abnormality:
# (femur, tibia, NOF)
dislocation (hip)
OA
growth disturbance

Question 8

trendelenburg test

Answer 8

hip drops due to:
WB side - abductor instability/weakness/wasting
pain - OA inhibiting muscles
nerve damage
developmental

results in trendelenburg gait (waddling)

gluteus medius - main hip abductor
1 - abducts hip on WB side
2 - supports contralateral lifted leg

Question 9

thomas test

Answer 9

thigh rises - FFD:
tightening/shortening hip flexors
OA

Question 10

hip - neurovascular - power

Answer 10

quadriceps - femoral
toe extension - common peroneal
foot plantarflexion - tibial

Question 11

hip - neurovascular - sensation

Answer 11

anteromedial thigh - femoral
foot dorsum - common peroneal
sole - tibial

Question 12

hip - neurovascular - vascular

Answer 12

posterior tibial + dorsalis pedis

Question 13

hip - feel

Answer 13

tenderness
bony abnormality (eg osteophytes)
trochanteric bursitis (trauma, OA)

Question 14

hip - internal rotation - degrees, limitations

Answer 14

40

limited + painful - hip OA (rotation oft affected early - painful + loss of internal rotation oft first sign in OA)

Question 15

hip - external rotation - degrees

Answer 15

30

Question 16

hip - abduction - degrees, limitations

Answer 16

45

limited - OA

Question 17

hip - adduction - degrees

Answer 17

30

Question 18

hip - extension - degrees

Answer 18

30

Question 19

indications THR

Answer 19

OA

displaced intracapsular # NOF if young/fit

Question 20

blood supply to femoral head

Answer 20

cervical arteries - run in capsule retinaculum
intramedullary vessels - in femoral neck
vessels of ligmentum teres

Question 21

displaced intracapsular # NOF - effects on blood supply

Answer 21

interruption of intermedullary vessels + PROB cervical arteries
high risk of AVN femoral head

Question 22

management - displaced intracapsular # NOF

Answer 22

older pts - hemi-arthroplasty (just replace head of femur)

younger/active pts - THR

Question 23

undisplaced intracapsular # NOF - effects on blood supply + management

Answer 23

interruption of intermedullary vessels + POSS cervical arteries
moderate risk AVN

internal fixation - fit
hemiarthroplasty - unfit

EE book says pin and hope for the best

Question 24

extracapsular # NOF - inter/subtrochanteric

Answer 24

little interruption to blood supply to femoral head

stablise + DHS

Question 25

hip extensors

Answer 25

gluteus maximus

hamstrings

Question 26

hip abductors

Answer 26

gluteus medius + minimus

Question 27

hip adductors

Answer 27

adductor magnus, longus, brevis

Question 28

hip flexors

Answer 28

A SPA TRIP

adductor brevis
sartorius
pectineus
adductor longus
tensor fasciae latae
rectus femoris (a quadricep)
iliacus
psoas

Question 29

differentiating sciatica, facet joint pain and hip joint pain

Answer 29

sciatica - sharp, sudden, to foot
facet joint - aching, from back
hip joint - groin, radiates to medial knee

Question 30

hip - relevance of antalgic gait

Answer 30

painful hip causes it - body leans to affected side + reduced duration of WB