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Ortho Test 1 > Hip > Flashcards

Hip Flashcards

1
Q

who is most likely to get a cam impingement

A

20-30yom

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2
Q

what does the iliofemoral ligament do?

A

it limits extension, adduction, and ER

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3
Q

describe coxa valga (3)

A
  1. angle >135
  2. less shock absorption
  3. accelerated degeneration
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4
Q

what is synovial chondromatosis?

A

multiple bone or cartilage loose bodies that shows up as “popcorn” on imaging

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5
Q

what are the six non arthritic sources of hip joint pain?

A
  1. FAI
  2. structural instability
  3. acetabular labral tears
  4. osteochondral lesions
  5. loose bodies
  6. ligamentum teres injury
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6
Q

what is the general definition of FAI

A

abnormal contact between the femur and acetabulum resulting in labral and chondral damage

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7
Q

what type of cartilage is on the head of the femur?

A

hyaline

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8
Q

what is the neural supply to the anterior hip joint and where does the pain refer?

A

femoral nerve L2-L4 lends to groin and anterior medial thigh pain

obturator nerve L3-L4 lends to medial thigh pain (no groin)

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9
Q

describe OA pain

A

deep aching poorly localized and presents gradually over years; severe has episodes of sharp pain

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10
Q

what is grade A evidence for flexibility and strength training?

A

1-5x/wk for 6-12 wks for mild-mod hip OA

hip flexors and ER stretching

hip extensor, abductor, and ER strength

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11
Q

what 3 things cause OA

A
  1. abnormal anatomy
  2. excessive load
  3. combination of both
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12
Q

describe coxa vara (3)

A
  1. angle <120
  2. less arthrosis
  3. high risk of stress fracture
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13
Q

what is the grade C weak evidence to dx FAI?

A
  1. anterior hip/groin pain or lateral hip/trochanter pain
  2. aching or sharp pain
  3. agg by sitting
  4. pain reproduced by hip flexion adduction, and IR (FADIR)
  5. hip IR <20 with hip flexed to 90
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14
Q

is the femur anteverted or retroverted?

A

normal physiologic anteversion

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15
Q

how does excessive anteversion present? (3) who is impacted?

A
  1. in toeing
  2. patellar squint
  3. excessive IR, decreased ER

boys 2:1

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16
Q

what are the treatment grades for hip problems and why is it important

A 
manual - F
education - F
stretching - F
strengthening - F
cardiopulm endurance - F
NMR - F

treat. what. you. find.

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17
Q

how does excessive femoral retroversion present? (2)

A
  1. excessive ER, decreased IR

2. out toeing

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18
Q

what vascular supply is compromised in hip neck fracture?

A

branches of the lateral circumflex

19
Q

what is important about the ligamentum teres

A

it is a conduit for the foveal artery (not present in everyone)

20
Q

is radiography useful in dx hip OA?

A

it is the gold standard, but can only identify joint space narrowing, sclerosis, and osteophytes in severe hip OA

21
Q

although there is no cure for OA, what three things amend to intervention

A
  1. addressing ROM
  2. strength
  3. functional limitations
22
Q

how long is conservative hip management prior to surgery?

A

8-12 weeks

23
Q

what is the neural supply to the posterior hip joint and where does the pain refer?

A

sacral plexus L4-S4 lends to buttock pain

24
Q

what is grade A evidence for measuring OA for pain and function?

A

WOMAC and VAS for pain

WOMAC LEFS and HOOS

6MWT, 30second STS, TUG, timed SLS, 4square

25
Q

what vascular supply is compromised in hip dislocation?

A

artery to the head of the femur

26
Q

what is grade C weak evidence for dx of intraarticular injuries excluding FAI

A
  1. anterior groin pain or generalized hip pain
  2. FAID or FABER +
  3. popping, locking, snapping
  4. instability
27
Q

what is cam FAI

A

femoral head asphericity related to slipped capital femoral epiphysis

28
Q

what are three examples of hip anatomical abnormalities

A
  1. CHD
  2. FAI
  3. LCP
29
Q

which category of FAI is most common

A

combo

30
Q

what are the 3 categories of FAI

A

cam, pincer, and combo

31
Q

what is grade A evidence of hip OA? 5

A
  1. age >50 — #1 RF!!!
  2. moderate ant/lat hip pain during WB
  3. morning stiffness 30-60min
  4. hip IR <24
  5. hip flexion discrepancy of >=15
32
Q

what is LCP

A

permanent deformity of the femoral head due to blood flow disruption in children 4-8yrs. good prognosis if dx before 6yo

33
Q

where would you use STM on an OA pt? (5)

A
  1. iliacus
  2. hip ERs
  3. post glute med
  4. QF
  5. glute max
34
Q

what does the ischiofemoral ligament do

A

it limits extension, abduction, and IR

35
Q

what are the two artery branches from the femoral artery that supply the hip?

A

femoral head artery and lateral circumflex branches

36
Q

what is the MOI for a labral tear?

A

forceful rotation with hip in hyperextension, but typically not assoc with any specific event

37
Q

what is slipped capital femoral epiphysis - who does it effect

A

growth plate fracture resulting in femur epiphysis slippage - common in obese male adolescents

38
Q

what is pincer FAI

A

acetabular abnormalities

39
Q

who is most like to get a pincer FAI?

A

women in 30s-40s notice after yoga and aerobics

40
Q

what five features characterize a hip OA

A
  1. focal articular degradation
  2. thickened subchondral bone
  3. osteophytes
  4. mild/mod synovial inflammation
  5. thickened capsule
41
Q

what is the close pack position of the hip?

A

trick question, there is a bony and a ligamentous close pack position

ligamentous: max extension, IR, abduction
bony: 90 deg flexion, moderate abduction, and ER (faber position)

42
Q

why is the center edge angle/angle of wiberg relevant??

A

if this vertical angle is <25, there is a higher risk of dysplasia, dislocation, and arthritis

43
Q

what is the loose pack position of the hip?

A

30 deg flexion, abduction, and slight ER

44
Q

what does the pubofemoral ligament do?

A

it limits extension, abduction, and ER

Ortho Test 1 (6 decks)

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