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OCS Prep > Hip > Flashcards

Hip Flashcards

1
Q

What is the CPG for DX of Hip OA?

A
  • Adults >50
  • Reports moderate pain in lateral or anterior hip with WB
  • Morning stiffness < or = to 60 min.
  • Pain with hip IR and hip IR less than 15 degrees
  • Hip flexion less than 115 degrees
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2
Q

What are the CPR for Hip OA?

A
  • squat is an aggravating factor
  • AROM hip extension causes pain
  • AROM Hip flexion causes lateral pain
  • Scour test with addiction causes lateral hip/ groin pain
  • PROM hip IR < 25 degrees
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3
Q

Name three self reported outcome measures that are considered to have strong evidence for activity limitations in patients with Hip OA.

A
  • WOMAC
  • LEFS
  • Harris Hip Score
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4
Q

List four functional measures that are considered strong evidence for measuring functional deficits in Hip OA.

A
  • 6 minute walk
  • 30 second chair stand test
  • timed up and go test
  • stair measure
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5
Q

What are two types of FAI?

A
  • CAM impingement
    • increased femoral neck diameter
  • Pincer impingement
    • increased acetabular depth
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6
Q

What are characteristics of CAM impingement.

A
  • Typical in men 20-30 years of age
  • Shears at chondrolabral junction as it enters the acetabulum during hip flexion
  • results in chondolabral seperation
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7
Q

What are characteristics of pincer impingement?

A
  • Typical in women 30-40 years old
  • overcoverage crushes the labrum against the normal femoral neck in flexion and IR.
  • results in labral degeneration without chondral injury
  • possible ossification of rim
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8
Q

What are the signs of FAI?

A
  • C/O
    • c sign
    • anterior groin pain
    • pain with sitting, standing, walking, and sports activities
    • sharp pain with clicking
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9
Q

What are the symptoms of FAI?

A
  • Muscle weakness(abd, flex and add)
  • gait limitations
  • joint mobility deficits
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10
Q

What special tests can you use to diagnose FAI?

A
  • FABER
  • FADIR
  • resisted SLR
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11
Q

What is a sports hernia?

A
  • Weakness of the posterior inguinal wall without a clinically palpable hernia.
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12
Q

What is the consensus meeting cluster to diagnose a sports hernia?

A
  1. Pinpoint tenderness over the pubic tubercle at conjoined tendon
  2. Palpable tenderness over the deep inguinal ring.
  3. Pain with no obvious hernia.
  4. Pain at the origin of the adductor log us tendon.
  5. Dull, diffuse pain in the groin.

Need 3/5

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13
Q

Manual therapy is considered to have ___________ evidence for treatment in hip OA

A

Strong

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14
Q

Patient education - teaching activity modification, supporting weight reduction and methods of off loading are considered to have ________ evidence according to CPG.

A

Moderate

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15
Q

According to CPG, functional gait and balance training, weight loss and an individual prescription for therex are considered to have _______ evidence

A

Weak

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16
Q

According to CPG, flexibility, strengthening and endurance exercises are considered to have ___________ evidence to support the use as an intervention in treating hip OA.

A

Strong

17
Q

What treatments can you use to treat patients with FAI.

A
  • Trigger point massage of RF, TFL, glute med
  • Lumbar spine mobilizations - grade 3-4
  • Hip capsule distraction( mulligan w/ movement)
  • electroacupuncture at L2-5
  • rehab exercises for strength,endurance and lumbopelvic stability
18
Q

Is an MRI effective in diagnosing Hip OA?

A
  • No

- SR for MRI- Sn 61%, Sp 82%; -LR .47, +LR 3.4

19
Q

What is the CPG for diagnosing FAI?

A
  • Sharp or aching pain in the anterior hip/groin and or lateral hip.
  • Pain is aggravated by sitting.
  • FABER +
  • Hip IR<20 degrees with hip at 90
  • Limitations with hip abd and flexion
  • treatment with HVLA, low amp traction and rotational manip/mobs
20
Q

What outcome measures show level 1 evidence for the hip?

A
  • Hip outcome score
  • HAGOS - young population
  • International Hip outcome Tool(iHOT 33) MCID s/p arthroscopy 6 points
21
Q

Characteristics of Hamstring syndrome- sciatic nerve entrapment

A
  • Associated with active individuals; distance runners, sprinters, jumpers
  • Pain with sitting, resisted knee flexion with hip flexed to 90
  • pain free resisted knee knee flexion with hip extended
    • do not perform HS stretching
    • have them sit on dorsal wedge pillow
    • gentle neural mobilizations
22
Q

Hamstring tendinopathy

A

Microtraumatic loading of the tendinous junction

  • (+) Pain with resisted knee flexion, hip flexed to 90
  • (-) slump, SLR
  • transverse friction massage, gentle hs stretching, gradual eccentric activation
23
Q

Illiopsoas bursitis

A
  • TTP along bursa
  • anterior hip pain, worse with passive hip extension and resisted hip flexion
  • May complain of snapping
24
Q

Trochanteric bursistis

A
  • treat with rest, NSAIDs, ice

- posterior taping to glut med

25
Q

Calcified tendinitis/ glut med tear

A

Treatment

- injections, heel lifts, avoid crossing legs

26
Q

Groin pain diff diagnosis

A

Adductor tendinopathy- (+) Pain with resisted hip add with hip neutral
Gracious tendinopathy- (+) Pain with resisted hip add and resisted knee flexion
Pectineus tendinopathy-(+) Pain with resisted hip hip flexion and add ( hip 90)
Illiopsoas tendinopathy- (+) Pain with resisted hip flex. And ER

27
Q

Pubic symphysis Pain

A

Pain with resisted hip add with hip at 45

  • can be decreased with stabilization belt
  • (+) active SLR
28
Q

Symptoms of osteitis pubis

A
  • Severe groin pain from isolated or repetitive trauma to pubic symphysis
  • Seen during vaginal birth or with athletes with rapid acc/deceleration.
    • rest, NSAIDs, PT, prolotherapy
29
Q

Symptoms of sports hernia

A

Experience twisting or tearing of transversalis fascia

  • Pain with resisted double hip add, unchanged with pelvic ring stabilization
  • Pain with resistive hip test and oblique abdominals
30
Q

Symptoms of o treat obturator nerve entrapment

A

Worse with resisted hip add

  • c/o post exercise adductor weakness and parasthesia in medial thigh
  • confirmed with emg and diagnostic nerve block
31
Q

Lateral femoral cutaneous nerve entrapment

A
  • sensory changes to lateral thigh or knee

- possibly quad weakness

32
Q

Symptoms of stress fracture for hip

A

Immediate onset of hip pain upon weight bearing

- need bone scan or mri

33
Q

Slipped Capital Femoral Epiphysis (SCFE)

A

Seen in adolescent males
+ groin pain that prohibits weight bearing in functional activities
+ limping/ waddling gait, limited hip rom
- treatment with percutaneous surgical pinning/ fixation, pwb crutches- 3 weeks
- strengthens hip abductors

34
Q

Symptoms of Leg Calve Perthes

A
  • AVN of femoral head, boys> girls
  • treatment : conservative management, remodeling through bed rest with traction in hip abd, serial casting, functional orthosis, to allow WB while maintaining hip abd and IR
35
Q

AVN

A
  • seen in 4 th decade
  • imaging unless advanced would not show any findings for three months
  • sickle cell anemia, gout, alcoholism, steroid usage, renal disease, radiation, trauma from previous Injury

OCS Prep (7 decks)

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