Hip Flashcards
common age for transient synovitis and legs-calve perches disease and slipped capital femoral epiphysis
transient synovitis- 2-10
Legg-calve-perthes- 2-8
slipped capital- 10-14
Common age for femoral neck stress fx, snapping hip, AVN, OA
neck fx- 14-30s,65+
Snapping hip- 20-30s
AVN- 20-40
OA- 30s-60
What is the lig ant, inf, and post of hip and what do they limit
ant- Iliofemoral (limits hyperext)
inf- Pubofemoral (limits hyperabduction)
post- Ischiofemoral (limits hyperextension)
When is there a loss of abduction and int rot what does it indicate
hip disease
What are the red flags of the hip
- Rheumatologic conditions
- Inf
- Tumors
- stress fx/ any fx
- AVN, LCP, SCFE
- Congenital dysplasia of hip
- AAA
What % of hips display abnormalities and have labral lesions
70%!
What is the potential series of events that lead to LBP due to reduced hip motion
- reduced hip motion –> +/- capsul stiffness –> altered loading –> tissue stress/sensitizations
What are the mc hip probs associated with cLBP
hip jt pain, morning stiffness, pain w int rot
hip spine syndrome in elderly aspects
limited hip mobility and rom (surgical hip correction can positively influence the LBP)
What type of OA is LBP a poor prognostic factor for
hip oa
but not knee oa
What is the presentation and cause of myositis ossificans
Damage to mm with hematoma due to forceful stretching after injury, deep massage etc
-Direct blow followed by swelling and decreased ability to flex the knee
Hip pointer- onset/cause, treatment, prognosis
Direct trauma/fall on hard surface (disabling contusion of iliac crest)
tx- modalities/rest/ice/rom
prog-3weeks
Avulsion/apophyseal injury- cause, dx, tx
-skeletally immature its, any mm attachment, eccentric force
dx- pain/bruising + x ray
Tx- modalities/rest/ice/rom
presentation of post hip dislocation and complications associated
flex/adducted/int rot
disclocation is med emergency
complications- fx, oa
causes of hip instability and symptoms
causes- repetitive microtrauma from axial loading/ext rot, generalized lig laxity, collagen disorders
symptoms- pain, psoas/ITB snapping/ apprehension/ recurrent instability
What are 3 types of bursitis
Trochanteric
Ischial (direct blow, prolonged sitting)
Iliopectineal (deep to psoas tendon)
Symptoms of Greater trochanteric pain syndrome
- chronic contnous or intermittent pain
- increased pain w activity
- local palpation of GT area recreates pain
- supine resisted hip ext rot
- single leg stance
common demographic for gluteal tendinopathy
mc females 40+
in 35% of those w lbp
tx of bursitis/gtps/gluteal tendinopathy
anti-inflammatory measures (rest/ice/modalities), soft tissues work, corticosteroid inj
Snapping Hip syndrome- presentation, pathology
pres- snapping sensation with fear of dislocation
Pathology- Tendons become inflamed or irritated from rubbing over burs/bony prominances (mc GT)
Adductor strain- cause, tests, risk factor
cause- forceful contraction in stretched pos (prox damage)
tests= direct palp*, fabre, resisted adduction
risk- decrease bilateral him ROM
Hamstring strain- MOI, what type of injury has longer recovery
MOI- forced flexion of hip+ knee extension or excessive contractile force
More prox the injury= longer recovery
moi of piriformis syndrome and features
moi- contracture/spasm, prolonged ext pressure, congenital variations in sciatic n, piriformes hypertrophy/fascia changes
symptoms- buttock pain, pain w sitting, tenderness of sciatic notch, pain in piriformic activity
pathology and presentation of sports hernia
path- bulge or post inguinal wall hernia without presence of true hernia. Abnormalities of RA, partial avulsion of IO, abnormality of EO
Presentation- high performance athletes, inguinal canal pain, dilated superficial inguinal ring, increased pain w coughing/straining/palp
pain increases 6-24hrs after strenuous activity
