Hip and Knee Q and A's Gindl Flashcards
Positive Fabere Patricks Test
-What does it indicate?
Acetabular hip pain, and or lack of motion
-Indicates hip joint pathology
What is part 3 of Fabere Patrick’s Test?
Dr. stabilizes the opposite ASIS and presses down on the femur to bring the hip into extension
What is the most common hip pathology in the elderly?
DJD causing arthritic pain
What are the 2 most common hip joint pathologies in the very young?
Legg-Calve-Perthes Disease
Slipped Capital Femoral Epiphysis
What is the most common cause of hip pain?
Subluxation
Positive Hibb’s Test
-What does it indicate?
Pain upon internal rotation at the hip
-Hip joint pathology
Positive Thomas Test
-What does it indicate?
Elevation of the straight leg (hip flexion on the side of the straight leg)
-Contracture of the hip flexors
A positive Thomas Test most commonly involves contracture of what hip flexor?
Iliopsoas
Positive Trendelenberg Test
-What does it indicate?
Weakness on the standing leg side (gluteus medius) while the raised leg side drops forward and down
-Deterioration/weakness of the pelvic stabilizer muscles (extensors or abductors)
How to check for fluid motion of the hip
Perform part 1 of Fabere Patricks Test. With the knee bent and the hip flexed press the femur in to the acetabulum. Feel for spinginess (end fell with bounce) vs. a hard end feel with the loss of motion.
Indications that Hip Traction is needed?
Loss of motion with Hibb’s or Fabere Patrick’s Tests or hip telescoping; Sharp or dull pain at the hip
Osteoarthritis
What is the most important thing about setting your contact for Hip Traction?
Triple Flexion (hip, knee, and pelvis each flexed to 90 degrees) is performed in order to place the Dr’s forearm under the ischial tuberosity. Dr. will stand opposite and inferior while reaching with the superior arm to place the posterior aspect of the forearm under the ischial tuberosity. The fingers of the Dr’s contact hand reach laterally, out from under the patient’s pelvis.
How to carefully keep your forearm away from the patient’s privates or pubis during hip traction?
Explain what you are about to do before you do it! Make sure that the doctor stance is inferior and that triple flexion is used to place the contact point under the ischial tuberosity. The Dr’s contact arm is at an oblique I-S angle with the fingers pointed laterally out from under the pelvis.
What do you do after setting your contact point for hip traction?
Bring the foot and leg down at an oblique angle until the thigh is tight against your forearm
How do you know that the hip joint is tractioning open during hip traction?
Two possibilities:
1) Visualize the hip joint
2) Dr places their forearm along the patient’s femur with the fingers palpating over the greater trochanter. The Dr’s elbow will squeeze the lateral aspect of the femur medially to open up the hip joint whoch the fingers should be able to feel
What is the most common tear of the knee ligaments?
1st = medial menisci
2nd = MCL
3rd = ACL
Positive anterior drawer sign
-What does it indicate?
Excessive motion P-A or increase in pain
-ACL tear
How do you stabilize for Anterior Drawer Sign?
Stabilize the patient’s anterior foot with your posterior thigh while the patient’s knee is flexed
Loss of motion on the Anterior Draw Sign indicates what knee subluxation?
Tibia P
What test would you run if you suspected a false negative on anterior draw sign?
Lachman’s
What test would you run after Anterior Draw Sign to verify a ACL damage and laxity?
Lachman’s
Positive Posterior Draw Sign
-What does it indicate?
Excessive motion A-P or increase in pain
-PCL tear. Not as common as ACL tear. Can perform Sag Sign to double check.
Positive Lachman’s Test
-What does it indicate?
Excessive motion P-A or increase in pain
-ACL tear
What is the orthopedic test of choice for the ACL?
Lachman’s