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MSK > HIP AND PELVIS > Flashcards

HIP AND PELVIS Flashcards

1
Q

apophyseal injuries and avulsion fractures (SCFE)

A

young athletes

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2
Q

ankylosing spondylitis

A

15-35 y/o; M

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3
Q

SI joint hypomobility

A

40-50 in M; >50 in F

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4
Q

congenital hip dysplasia

A

infants; F, adolescents and young adults

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5
Q

Legg Calves-Perthes Disease

A

3-12 y/o; M

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6
Q

osteoporotic femoral neck fractures

A

elderly women; pregnancy or menopause (first to inspect in elderlies)

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7
Q

OA

A

> 60 y/o

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8
Q

symphysis pubis pain

A

localized; inc pain when adductor and rectus abdominis is moving

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8
Q

SI jt pain

A

constant, unrelieved by position

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8
Q

pain around psis and buttocks

A

sacroiliac problem
point sign; Fortin finger test (inferior and medial to psis)
sometimes referred to the posterior thigh
suspects hamstrings or adductors
tender erector spinae and immobile pelvis

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9
Q

posterior, posterolateral, posteromedial

A

posterior sacroiliac ligament

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10
Q

anterior groin pain

A

intra articular, iliopsoas, adductor, labral, chondral injuries, tendinitis, FAI, athletic pubalgia

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11
Q

FAI

A

anterolateral impingement of femoral neck or head on acetabular rim due to its abnormal relationship; FLADIR, referred to buttocks, greater troch, thigh, and medial knee

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12
Q

anterior hip

A

groin strain, iliopsoas, adductors, labral tears, joint capsule, impingement of hip muscles (origin insertion)

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13
Q

lateral hip

A

extra articular, piriformis syndrome, abductors, g med/ g max tear, snapping hip, tendinitis, GTPS, acetabular dysplasia, abductor injuries, L4

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14
Q

lateral hip due to g med tendinitis

A

rare: abductor strain
abductor strain + post thigh pain= adductor magnus (deep hamstrings)

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15
Q

C sign:

A

cusp greater trochanter (anterior groin); hip at fault

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16
Q

sitting with legs crossed

A

trochanteric bursitis

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17
Q

distal iliopsoas strain

A

forward kick; ASIS and symphysis pubis

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17
Q

sitting with legs uncrossed

A

ischiogluteal bursitis

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18
Q

proximal adductor strain

A

side kick; ASIS and symphysis pubis

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19
Q

isolated posterior buttock pain

A

lumbar or sacroiliac (sciatic)

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20
Q

insidious

A

osteoarthritic

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21
Q

sudden

A

mechanical, strain, avulsion fx

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22
Q

instability

A

intra articular problems (labral tears, end range movements, acute trauma) with aching, locking, and latching

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23
Q

locking

A

inability to move (severe)

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24
Q

latching

A

easily resolved, temporary

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25
Q

posterior dislocation

A

FADIR, shortened leg, prominent greater trochanter

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26
Q

anterior dislocation

A

EXABER, swollen femoral triangle

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27
Q

clicking, locking, or catching

A

looseness or stiffness
common in labral tears during er and ir movements

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28
Q

internal snapping/ internal coxa saltans

A

iliopsoas slipping on lesser trochanter or acetabular rim
iliofemoral ligament overriding on the femoral head
hamstring syndrome
iliopsoas bursa/ capsular thickening
felt at 45 deg flexion

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29
Q

external snapping/ external coxa saltans

A

ITB on iliopectineal eminence, greater trochanter, femoral head felt on flexion
glute max overriding on greater trochanter during extension
trochanteric bursitis

30
Q

intra articular snapping

A

labral or ligamentum teres tears
loose bodies
synovial chrondomatosis
displaced fx
OA
capsular instability
common in 20-40 y/o

31
Q

triple impingement

A

internal snapping + labral tears + FAI

32
Q

functional limitations

A

sit to stand, prolonged sitting, turning in bed, walking (transitional movements)

33
Q

sudden axial loading and rotation of LE

A

sacroiliac dysfunction
complaints of back pain
over kicking and landing on an anterior pelvic tilt

34
Q

falls

A

osteoporotic femoral neck
trochanteric problems

35
Q

hitting flexed knee and force on hip

A

labral tears/ dislocations

36
Q

traction of muscles

A

sprinting, kicking, and sudden change of movements
overstretching and over contraction

37
Q

repetitive loading on femoral neck

A

postural deviations

38
Q

CAM FAI

A

excessive end range internal rotation
common in basketball players, soccer, and hockey; young adult makes of 20-40 y/o
femoral head is big for acetabulum
abnormal femoral head
flattened femoral head (head tilt deformity/ pistol-grip deformity)= shearing of labrum
inc stress on symphysis pubis and precursor to athletic pubalgia
inclusion
more common

39
Q

Pincer Type

A

excessive end range external rotation
common in ballet dancers, gymnasts older females (40+)
over coverage of acetabulum on femoral head leading to impingement of femoral neck
can occur with CAM or isolated
impaction
side split and kicks

40
Q

CAM + Pincer

A

instability
pelvic drop and hike
giving way
apprehension
tight iliopsoas

41
Q

obesity

A

risk for hip hypomobility and osteoporosis
back pain

42
Q

scoliosis

A

hip hiking= leg length discrepancy

43
Q

pregnancy

A

check for acuteness of labor
sacrotuberous ligament is stressed (sprain)
3-4 mos before it returns to normal
core strength problem
diastasis recti= linea alba, widened pelvic outlet

44
Q

kegel test

A

pelvic floor exercises

45
Q

acute

A

steps/ distance inside the house; toiletry

46
Q

chronic

A

steps/ distance outside the house; participation restriction

47
Q

alcohol, corticosteroids, and tobacco use

A

osteonecrosis of femoral neck

48
Q

varicosities

A

distended vessels d/t overactivity (knee)

49
Q

trendelenburg gait/ abductor lurch

A

lateral pelvic tilt >2cm on WB side with trunk inclination

50
Q

anterior pelvic tilt (msk)

A

counternutation
lengthened external oblique and rectus abdominis
tightened: rectus femoris and iliopsoas
lower crossed syndrome
>weak: glute max and rectus abdominis
> tight: iliopsoas and erector spinae
at the knee
lengthened quads
tightened hamstrings

51
Q

posterior pelvic tilt

A

nutation
dec lumbar lordosis
lengthened erector spinae and hip flexors
tightened hamstrings and rectus abdominis

52
Q

forward shifted pelvis

A

chronic anterior pelvic tilt
compensatory position

53
Q

neutral pelvis

A

horizontal line of ASIS and PSIS
average: 11 plus minus 4
normal: 7-15

54
Q

in toeing

A

femoral anteversion

55
Q

out toeing

A

femoral retroversion

56
Q

pelvic hike

A

higher iliac crest on one side compared to the other
tight gmed and quadratus lumborum

57
Q

pelvic upslip

A

ASIS and PSIS is higher on one side compared to the other
muscle spasm

57
Q

miserable malalignment

A

femoral anteversion, IR, genu valgum, pronation of foot, external tibial torsion
strengthen external rotators and tibialis anterior

58
Q

flex rom

A

120

59
Q

ext rom

A

20

60
Q

ir rom

A

45

61
Q

er rom

A

45

62
Q

abd rom

A

40

63
Q

add rom

A

20

64
Q

abduction

A

quadratus lumborum and external obliques should not contract

65
Q

abduction with slight flexion

A

weak glute med and stronger TFL

66
Q

abduction with ER on extension

A

stronger iliopsoas and piriformis

67
Q

limited extension

A

added stress on L3-L4, L4-L5 (hip-spine syndrome)

68
Q

forward flexion

A

40 deg: sacrum moves forward
60 deg: sacrum moves backward

69
Q

standing hip flexion

A

PSIS must drop
PSIS moving superiorly: hypomobility (napagiwanan)

70
Q

sacral flexion test

A

sacrum must not move

71
Q

normal pattern of extension

A

gmax –> contralat erector spinae –> hamstrings

72
Q

hyperextension

A

if erector spinae contracts first

73
Q

sacral rotation test

A

sacrum rotates on same side
PSIS must move forward

74
Q

flamingo test

A

stand on one leg
weight of trunk causes sacrum to shift forward and caudally; ilium moves to opposite side
+pain

75
Q
A

MSK (6 decks)

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