hip

Question 1

hip rom

Answer 1

flexion 120
abduction 45
IR 45
ER 45
extension 30

Question 2

hip open pack

Answer 2

30 deg flexion
30 deg abduction
slight ER

Question 3

hip closed pack

Answer 3

ligamentous: full extension, abduction, IR
bony: 90 deg flex, slight abduction, slight ER

Question 4

what pathology?

head of the femur doesn’t receive enough blood and dies

Answer 4

Legg-Calvè-Perthe

Question 5

Patrick’s Test aka?

purpose?

Answer 5

FABER Test, figure 4 position

hip or SI joint pathology.

Question 6

hip ROM needed for gait

Answer 6

20-30 flex - initial swing to loading response

10 extension - terminal stance

Question 7

what test?
baby is positioned in supine with the hips flexed to 90 degrees and the knees flexed. The therapist abducts the patient’s hips and applies gentle pressure to the greater trochanters until resistance is felt at approximately 30 degrees.
Positive test is indicated by a click or a clunk and may be indicative of a dislocation being reduced.

Answer 7

Ortalani test for hip dysplasia

correct with Barlow (go Out to the Bar)

Question 8

what test?
baby positioned in supine with the hips flexed to 90 degrees and the knees flexed. The therapist tests each hip individually by stabilizing the femur and pelvis with one hand while the other hand moves the test leg into abduction while applying forward pressure posterior to the greater trochanter.
- Positive test is indicated by a click or a clunk and may be indicative of a hip dislocation being reduced.

Answer 8

negative Barlow test would indicate the absence of a hip dislocation being reduced.
for hip dysplasia: Ortalani to dislocate, Barlow to reduce dislocation

Question 9

what test?

• Patient sitting with the knees flexed to 90 degrees over the edge of a table.
• Therapist passively extends one knee.
• Positive: tightness in the hamstrings or extension of the trunk in order to limit the effect of the tight hamstrings.

Answer 9

tripod sign evaluates hamstrings length

Question 10

MMT glute max vs hamstrings

• movement?
• difference in positioning?

Answer 10

hip extension
glute max - knee flexed to 90 degrees while extending the hip
hamstring - knee extended

Question 11

MMT what muscle?

• Patient sidelying, bottom leg flexed at the hip and knee.
• tested leg is abducted and slightly extended
• Pressure is applied against the top leg, proximal to the ankle, in the direction of adduction and slight flexion.

Answer 11

gluteus medius

Question 12

MMT what muscle?

• Patient prone, knee is flexed to 50-70 degrees with the thigh in a neutral position.
• Therapist applies pressure against the leg, proximal to the ankle, in the direction of knee extension.

Answer 12

hamstrings consist of the semitendinosus, semimembranosus, and biceps femoris

Question 13

normal pelvic angle?

increased pelvic angle leads to what?

Answer 13

30 deg

increased lumbar lordosis

Question 14

What test? what for?

Patient in prone and the knee flexed to 90 degrees. Move hip IR/ER.

Answer 14

Craig’s test - femoral anteversion

normal 8-15deg anteversion (IR)

Question 15

gait deviation?

piriformis syndrome

Answer 15

• shortening or spasm of the piriformis resulting in external rotation of the hip.
• stride length on the affected side will typically be shortened
• functional shortening of the affected limb - abnormal alignment and mechanics of the hip and pelvis
• decreased lumbar lordosis- reducing the distance between the origin and insertion.

Question 16

how to diagnose

Trochanteric bursitis from gluteal tendonitis?

Answer 16

Diagnostic injection is typically considered the most definitive means of confirming trochanteric bursitis. A corticosteroid and local anesthetic solution is injected into the bursa with the diagnosis confirmed if the patient experiences significant relief from symptoms.

Question 17

external snapping sensation over the lateral hip involves what tendon on greater trochanter?
- felt more laterally during hip flexion and extension, esp if hip IR and running

Answer 17

Iliotibial band

Question 18

Internal snapping caused by slipping of
- what tendon over lesser trochanter or anterior acetabulum?
- what ligament over head of femur?
occurs at approximately 45° of flexion when the hip is moving from flexion to extension, especially with the hip abducted and laterally (externally) rotated.

Answer 18

iliopsoas tendon

Iliofemoral ligament

Question 19

what pathology?

• snapping hip sensation
• generally sharp pain into the groin and anterior thigh, especially with pivoting movements.

Answer 19

Acetabular labral tears

Question 20

Posterior hip precautions after a total hip arthroplasty?

Answer 20

avoiding
hip flexion greater than 90° medial (internal) rotation of the hip
and adduction of the hip

Question 21

sacroiliac dysfunction pain with what activities?

why?

Answer 21

ggravated by
prolonged standing,
asymmetrical weightbearing, or
stair climbing;
pain can also stem from running, long strides, or extreme postures
why?
Weakness or insufficient recruitment and/or unbalanced muscle function within the lumbar/pelvic/hip region can reduce the force-closure mechanism required for sacroiliac joint stability, which can result in a sustained counternutation of the sacrum. This “unlocks” the mechanism, rendering the sacroiliac joint vulnerable to injury.

Question 22

pathology? common risk factor?

• adolescent patient
• pain in the groin, knee, or medial thigh
• antalgic pattern
• laterally (externally) rotated lower extremity
• onset is acute, the adolescent will be unable to bear weight on the affected extremity

Answer 22

Slipped capital femoral epiphysis

risk factor - obesity

Question 23

pathology?

• Teenager
• Symptoms hip or groin pain,
• gluteus minimus gait
• limited hip range of motion for medial (internal) rotation, flexion, and abduction
• tenderness to palpation over the hip joint
• femoral head is the most common site of the disorder
• symptoms may be mild initially and increase over time

Answer 23

Undetected childhood developmental hip dysplasia can result in a form of avascular osteonecrosis as early as adolescence or in adulthood

Question 24

pathology?

• typical occurrence ages of 3 to 13 years
• most commonly in physically active, yet small, boys.
• etiology of the disease is unknown
• Children often are smaller in stature and may have limb length discrepancies

Answer 24

Legg-Calvé-Perthes disease
It is an avascular necrosis that disrupts blood flow to the capital femoral epiphysis, progresses through four well-defined stages, and is ultimately self limiting.

Question 25

THA posterior approach - hip precuations

Answer 25

avoiding
hip flexion greater than 90°
hip medial (internal) rotation
hip adduction