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T OCS > Hip > Flashcards

Hip Flashcards

1
Q

Validated Hip outcome measures (non OA)

A

HOS- hip outcome score
Ihot- international hip outcome tool (ihot33)
Copenhagen ( HAGOS)- hip and groin outcome score

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2
Q

Hip outcome measure OA

A

WOMAC- Western Ontario and McMaster OA index
LEFS
Harris Hip Score

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3
Q

Hip OA interventions

A

Anti inflammatories, corticosteroid injections, manual therapy (B), Therex ( stretching, PRE, endurance) (B)

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4
Q

Hip OA CPR

A
  1. Stiffness < 60 min
  2. Age > 50
  3. Hip IR < 15 degrees
    - limited hip IR and flex < 15 degrees vs contra
  4. Pain with hip IR
  5. ESR < 45
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5
Q

Hip OA prognostic CPR

A
  1. age < 58
  2. 35.9 s or less on 40 m walk
  3. pain > 6/10
  4. Pain < 1 year
  5. unilateral hip pain
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6
Q

Inidications for hip scope

A
  1. failed conservative tx > 4 weeks

2. show signs of intra-articular hip pathology

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7
Q

Indications for labral repair

A
  1. labrum partially detached from acetabulum
  2. have intrasubstance tears
    - repair over resection performed to avoid significant disruption of joint mechanics
    - better outcomes with repair over resection
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8
Q

Hip Scope ROM and WB

A
  1. CPM 2-4 weeks postop 30-70 initially
  2. full PROM by 2 weeks- AROM starts 2 at weeks
    - isometrics starting day 2
  3. Usually FFWB with AC
  4. Avoid excessive ER for 4 weeks due to stretching of anterior capsuloligamentous structures
    - avoid flexion/ABD to prevent inflammation
  5. microfracture or osteoplasty PWB- Wolfs law
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9
Q

Peds hip pain 5-8 year olds

A

transient synovitis

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10
Q

Hip pain in adolescents (pre teens)

A

SCFE

  • groin, ant thigh, ant knee pain
  • limping
  • (+) drehman sign (ER and Abd with hip flex)
  • pain/ liminted ROM with hip IR
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11
Q

Developmental hip dyspagia

A

infants

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12
Q

Coxa Saltans (snapping hip) causes

A

Can be intra or extraarticular

Intraarticular
1. ilipsoas- over iliopectineal eminence

Extraarticular

  1. ilipsoas
    - over femoral head
    - (pectin pubis)
  2. ITB
    - over greater troch
  3. Glute max
    - over greater troch (posterior hip)
  4. Iliofemoral lig- over anterior femoral head
  5. Hamstring- over ischial tub
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13
Q

Femoral Triangle

A

Superior: inguinal ligament
Medially: adductor longus
Lateral: lat border of sartorius
Floor: Add longus, pectineus and iliopsoas

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14
Q

orientation of acetabulum

A

ventrally, laterally, caually

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15
Q

pubofemoral ligament

A

restrains ext, ER, ABD

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16
Q

ischiofemoral ligament

A

2 bands

  1. Pars superioris: restrics ext, ER, add
  2. pars inferioris: restrics ext
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17
Q

Flexion component movements

A

flex/abd/ir

18
Q

Ext component movement

A

ext/add/er

19
Q

Abd component movemnt

A

abd/ext/ER

20
Q

ADD component movement

A

ADD/flex/ER

21
Q

Peds hip pain 4-10 yo

A

transient synovitis, JRA, LCP

22
Q

Hip pain 15-25

A

Articular Osteochondritis dissecas

23
Q

Aching hip pain

A

bursitis, tendinopathy, arthritis or arthrosis

24
Q

Sharp pain

A

esp when combined with clicking/locking/instability= labrum; can also be loose bodies

25
Q

Groin pain with coughing sneezing or straining

A

Think hernia, sports hernia( tendinopathy of add longus or rectus abd), pubic symphyseal affliction, lumbar spine

26
Q

Posterolateral hip pain ddx

A

Trochanteric bursitis, piriformis syndrom, gluteal tendonitis, loosening from THR, referred pain from lumbar/SIJ

27
Q

Signs of a loose body (clinical triad)

A
  1. sharp radiating pain
  2. Non capsular loss of ROM with empty end feel
  3. instability, feeling like LE will give out
28
Q

Hamstring syndrome triad sx (sciatic nerve entrapment)

A
  1. pain with palpation to lateral ischial tub
  2. pain with resisted knee flexion with hip at 90 and knee extended to the limit
    - no pain with resisted knee flexion in prone
  3. pain with sitting
29
Q

hamstring tendonopathy

A

pain with resisted knee flexion in hip 90 or 0 flexion

no pain with sitting

30
Q

Trochanteric bursitis differential

A
  1. pain with palpation
  2. pain with FADER*, FADIR (less painful than tendonopathy)
  3. no pain with SLR
  4. pain with sitting
31
Q

Sports related groin pain

A

bilateral resisted hip ADD; accompanied by bone marrow edema

32
Q

Pelvic ring instability tx

A
  1. strengthen transversus abd
  2. strengthen pelvic floor muscles
  3. wear SI belt (23 hrs/day –> less)

Symptomatic with active SLR test
- alleviated with compression to pelvis (SI compression)

33
Q

Sportsmans hernia, “hockey hernia”, athletic pubalgia

A
  • weaknening /stressing on the transversalis fascia, conjoined tendon and interal oblique fibers, creating an inside out hernia within the dorsal wall of the inguinal canal
  • pain at lower ab, inguinal or groin regions exacerbated with valsalva or exertion
34
Q

Tests for hip stress fx

A
  • single leg hop
  • fulcrum test ( seated, hand weaved under involved side, over contra, and push down on involved side)
  • bone scan/MRI
35
Q

Neuralgia Parasthetica

A
  • lateral femoral cutaenous nerve entrapment

- best with injection or surgical management

36
Q

Calcific tendonitis

A

occurs with persistent bursitis.

37
Q

Iliopsoas bursitis

A
  • pain to anterior hip
  • pain with resisted hip flexion and passive hip ext
    Special tests
    1. snapping hip- supine- hip flex/add/ER then return to neutral- assess for hip click
    2. supine heel raise- resisted hip flex at 15 degrees
38
Q

Adductor strain imaging

A

ultrasound 84% sensitivity

Gadolinium enhances MRI- not great

39
Q

Tx for sports hernia

A

aka gilmore groin

  • Rest 6-8 weeks
  • ADD stretching/strengthening

can return to sports 10-12 weeks if painfree

40
Q

hamstring injury special tests

A

puranen orova- standing hamstring stretch
bent knee test- slow extension of knee with hips and knees maximally flexed
mod bent knee test- rapid ext of knee with hips and knees flexed
taling off shoes sign- biceps femoris- flexed knee that goes to take off shoes being tested

T OCS (16 decks)

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