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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
instability
intra articular problems (labral tears, end range movements, acute trauma) with aching, locking, and latching
23
locking
inability to move (severe)
24
latching
easily resolved, temporary
25
posterior dislocation
FADIR, shortened leg, prominent greater trochanter
26
anterior dislocation
EXABER, swollen femoral triangle
27
clicking, locking, or catching
looseness or stiffness common in labral tears during er and ir movements
28
internal snapping/ internal coxa saltans
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
29
external snapping/ external coxa saltans
ITB on iliopectineal eminence, greater trochanter, femoral head felt on flexion glute max overriding on greater trochanter during extension trochanteric bursitis
30
intra articular snapping
labral or ligamentum teres tears loose bodies synovial chrondomatosis displaced fx OA capsular instability common in 20-40 y/o
31
triple impingement
internal snapping + labral tears + FAI
32
functional limitations
sit to stand, prolonged sitting, turning in bed, walking (transitional movements)
33
sudden axial loading and rotation of LE
sacroiliac dysfunction complaints of back pain over kicking and landing on an anterior pelvic tilt
34
falls
osteoporotic femoral neck trochanteric problems
35
hitting flexed knee and force on hip
labral tears/ dislocations
36
traction of muscles
sprinting, kicking, and sudden change of movements overstretching and over contraction
37
repetitive loading on femoral neck
postural deviations
38
CAM FAI
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
Pincer Type
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
CAM + Pincer
instability pelvic drop and hike giving way apprehension tight iliopsoas
41
obesity
risk for hip hypomobility and osteoporosis back pain
42
scoliosis
hip hiking= leg length discrepancy
43
pregnancy
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
kegel test
pelvic floor exercises
45
acute
steps/ distance inside the house; toiletry
46
chronic
steps/ distance outside the house; participation restriction
47
alcohol, corticosteroids, and tobacco use
osteonecrosis of femoral neck
48
varicosities
distended vessels d/t overactivity (knee)
49
trendelenburg gait/ abductor lurch
lateral pelvic tilt >2cm on WB side with trunk inclination
50
anterior pelvic tilt (msk)
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
posterior pelvic tilt
nutation dec lumbar lordosis lengthened erector spinae and hip flexors tightened hamstrings and rectus abdominis
52
forward shifted pelvis
chronic anterior pelvic tilt compensatory position
53
neutral pelvis
horizontal line of ASIS and PSIS average: 11 plus minus 4 normal: 7-15
54
in toeing
femoral anteversion
55
out toeing
femoral retroversion
56
pelvic hike
higher iliac crest on one side compared to the other tight gmed and quadratus lumborum
57
pelvic upslip
ASIS and PSIS is higher on one side compared to the other muscle spasm
57
miserable malalignment
femoral anteversion, IR, genu valgum, pronation of foot, external tibial torsion strengthen external rotators and tibialis anterior
58
flex rom
120
59
ext rom
20
60
ir rom
45
61
er rom
45
62
abd rom
40
63
add rom
20
64
abduction
quadratus lumborum and external obliques should not contract
65
abduction with slight flexion
weak glute med and stronger TFL
66
abduction with ER on extension
stronger iliopsoas and piriformis
67
limited extension
added stress on L3-L4, L4-L5 (hip-spine syndrome)
68
forward flexion
40 deg: sacrum moves forward 60 deg: sacrum moves backward
69
standing hip flexion
PSIS must drop PSIS moving superiorly: hypomobility (napagiwanan)
70
sacral flexion test
sacrum must not move
71
normal pattern of extension
gmax --> contralat erector spinae --> hamstrings
72
hyperextension
if erector spinae contracts first
73
sacral rotation test
sacrum rotates on same side PSIS must move forward
74
flamingo test
stand on one leg weight of trunk causes sacrum to shift forward and caudally; ilium moves to opposite side +pain
75

MSK (7 decks)

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