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SCS Prep > Hip > Flashcards

Hip Flashcards

1
Q

Ligamentum Teres

A
  • transverse acetabular ligament to fovea capitis
  • strong intrinsic stabilizer, more taut with flex/abd/ER
  • may have proprioceptive role preventing excessive movement, distribute synovial fluid
  • dysfxn = deep ant groin pain, painful with forced flex/IR
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2
Q

Iliofemoral Ligament (Y)

A
  • AIIS/acet rim to introtroch line, 2 bands
  • Restricts hip ext allowing erect posture to be maintined
  • Primary restraint vs ext/ER
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3
Q

Ischiofemoral Ligament

A
  • Post acet rim to med fem neck/greater troch

- Restricts vs IR; add when flex

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4
Q

Pubofemoral Ligament

A
  • Sup pubic ram to intertroch line

- Primary restraint vs hyperabd and ER

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5
Q

Angle of Inclination

A
  • Angle between neck and fem shaft (normal 125-130 deg)
  • Coxa valga (inc angle)
  • Coxa vara (dec angle)
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6
Q

Coxa Valga

A
  • fem head directed more superiorly
  • joint reaction force now parallel to fem shaft = dec WBing surface
  • shortens hip abd, inc overall length of LE
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7
Q

Angle of Torsion

A
  • angle formed by fem neck and transverse axis of fem condyles
  • normal 12-15 deg
  • anteversion - fem neck excessively ant to condylar axis
  • retro - parallal to post
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8
Q

Increased Anteversion

A
  • Inc IR = toe in gait
  • toe in, subtalar pro, lat pat sublux
  • med tib/fem torsions
  • possible lat tib torion, lat rotation at knee, lumbar rot ipsi
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9
Q

Excessive Retroversion

A
  • toe out, subtalar sup
  • lateral tib/fem torsions
  • possible med tib torsion, lumbar rot contra
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10
Q

Athletic Pubalgia

A

sports hernia
- dec rot, inc pelvic motion = inc stress on pelvic stabilizers and breakdown

Special Test - HF sore, tender at add, rect abd insert tender origin during palpation of resisted contraction
Passive IR should exacerbate hip joint but not AP

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11
Q

Snapping Iliopsoas tendon

A
  • can be heard, snapping as it crosses ant fem head/capsule or pectineal eminence
  • clunk occurs as hip flex/abd/ER toward ext/IR
  • FABER into ext/IR = snap
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12
Q

Snapping ITB

A
  • can be seen, TFL flips back/forth over greater troch with hip rot
  • Ober Test
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13
Q

Localization of Symptoms

A

Anterior groin - L3 seg/derm (radiate into med thigh)
C-sign - deep int pain
Lat - bursitis or ITB
Post - lumbar or piriformis (even post intra-articular pathology refers ant to A/L)

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14
Q

Inspection

A
  • irritated hip slight flex while standing = LLD

- seated - slouching and listing to uninvolved side (slight less flex with abd/ER = relaxed capsule)

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15
Q

LLD

A

> 1.5 cm = significant

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16
Q

Impingement

A

Cam - head too big, pistol grip

Pincer - acet to big

17
Q

X-ray Angles

A
  • Alpha - midline of fem neck and line connecting fem head to head/neck junction (normal 45, > 50 - cam)
  • Center-Edge - center of fem head and lat corner of acet (20-25 deg, < 20 = dysplasia)
  • Angle of Inclincation
  • Tonnis Angle - sourcil (sclerotic WBing portion of sup acet); line between med/lat extents and angle to horizontal line parallal to inf aspect of isch tub (> 10 = dysplasia)

Crossover Sign - sup ant rim of acet more lat than post rim = acet retro (pincer)

18
Q

MRA vs MRI

A

MRA has greater Sn and less false positive

19
Q

Craig Test

A

femoral anteversion (8-15 normal)

20
Q

Log Roll

A

most Sp for intra-articular pathology; should produce ant groin pain, may produce sharp/catching

21
Q

Impingement (special test)

A

forced flex/IR

  • flex/add = approximates fem neck and acet rim
  • IR = shear force at labrum = sharp pain if chondral lesion present
  • may produce click
22
Q

Post Impingement

A

forced ext hip into ER

- ant trans of fem head = ant instability or possible pain trapping ant labral tear

23
Q

FABER

A

catching associated with labral/chondral lesions

- restricted abd/ER quantified by knee elevation off table (> fist or 10 cm)

24
Q

ASLR

A

forces several times BW across articular surfaces (more force than walking)

25
Q

FABER or Patrick

A

FABER with OP and L/S

  • pain in ant vs post hip
  • core resisted - test with ppt and sh ext; poor core strength mimics hip pathology
26
Q

Dial Test

A

ant lax or instability
- inc ER when limb resting in ext; relax - already in ER, passive OP = soft end feel
see post impingement

27
Q

Piriformis Syndrome

A

its an ER-er

  • Passive IR of extended hip (Freiberg’s Test)
  • Resisted ER of extended hip, resisted abd of flexed hip (Pace sign)
  • Passive FADIR = stretch = provoking symptoms
28
Q

Muscular Imbalance Screens

A

Pelvic tilt, Pelvic Rotation, Torso Rotation, SL bridge

SCS Prep (16 decks)

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