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MS II > Hip and Pelvis Soft Tissue > Flashcards

Hip and Pelvis Soft Tissue Flashcards

1
Q

If a patient reports of pain in the lateral thigh and is exacerbated when transferring from sitting to standing, what is your initial hypothesis?

a. OA
b. Labral Tear
c. Greater trochanteric bursitis or muscle strain
d. Avascular Necrosis

A

Greater trochanteric bursitis or muscle strain

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2
Q

If a patient is >60 y/o and reports of pain and stiffness in the hip with possible radiation into the groin, what is your initial hypothesis?

a. OA
b. Labral Tear
c. Greater trochanteric bursitis or muscle strain
d. Avascular Necrosis

A

OA

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3
Q

A patient reports of clicking and/or catching in the hip joint. Pain exacerbated by full flexion or extension, what is your initial hypothesis?

a. OA
b. Labral Tear
c. Greater trochanteric bursitis or muscle strain
d. Avascular Necrosis

A

Labral tear

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4
Q

Patient reports of a repetitive or overuse injury, what is your initial hypothesis?

a. Muscle sprain/strain
b. Labral Tear
c. Greater trochanteric bursitis or muscle strain
d. Avascular Necrosis

A

Muscle sprain/train

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5
Q

Patient reports of deep, aching throb in the hip or groin and a possible history of prolonged steroid use, what is your initial hypothesis?

a. OA
b. Labral Tear
c. Greater trochanteric bursitis or muscle strain
d. Avascular Necrosis

A

Avascular necrosis

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6
Q

Patient reports of pain in the gluteal region with occasional radiation into the posterior thigh and calf, what is your initial hypothesis?

a. Avascular Necrosis
b. Piriformis syndrome, hamstring strain or ischial bursitis
c. Greater trochanteric bursitis
d. Labral tear

A

Piriformis syndrome, hamstring strain or ischial bursitis

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7
Q

Hip pain is typically found in what area?

a. anterior or lateral groin area
b. posterior or medial groin area
c. anterior or medial groin area
d. posterior or lateral groin area

A

anterior or medial groin area

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8
Q

Lateral pain in the hip is usually _ or _ referred

A

trochanteric or L4 referred

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9
Q

Pain that may be due to SIJ, piriformis or L5-S1 referred is found

a. anteriorly
b. posterior
c. medial
d. lateral

A

posterior

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10
Q

Hip pain doesnt extend down the thigh towards the knee (true/false)

A

false

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11
Q

This type of bursitis is usually due to direct trauma or repetitive friction from IT band over the greater trochanter during flexion/extension

a. trochanteric bursitis
b. ischial bursitis
c. iliopectineal bursitis
d. ITB bursitis

A

trochanteric bursitis

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12
Q

This bursitis can be due to direct trauma or movement in sitting position

a. trochanteric bursitis
b. ischial bursitis
c. iliopectineal bursitis
d. ITB bursitis

A

ischial bursitis

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13
Q

This bursitis is anterior hip pain and can be difficult to differentiate from hip flexor strain

a. trochanteric bursitis
b. ischial bursitis
c. iliopectineal bursitis
d. ITB bursitis

A

iliopectineal bursitis

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14
Q

True hip pain is typically made worse by walking (True/false)

A

true

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15
Q

Pain from the lumbar spine can be due to

a. L5, S1
b. L1, L2
c. L2, L3
d. L3, L4

A

L2-L3

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16
Q

A patient presents with pain with weight bearing when they run, local pain, swelling and point tenderness over the greater trochanter, what could they be diagnosed with?

a. trochanteric bursitis
b. ITB bursitis
c. gluteus medius tendinosis
d. iliopectinal bursitis

A

trochanteric bursitis

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17
Q

Patient presents with sharp pain over the greater trochanter that progresses to a dull ache with activity and may recur

a. trochanteric bursitis
b. ITB bursitis
c. gluteus medius tendinosis
d. iliopectinal bursitis

A

trochanteric bursitis

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18
Q

What will you see in examination with trochanteric bursitis?

A 
usually no signs of trauma 
ITB tight
increased Q-angle 
crepitus over trochanter 
resisted abduction may be painful and gluteus may be weak
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19
Q

What will be seen with AROM and PROM with trochanteric bursitis?

A

pain AROM hip flexion and extension

pain with PROM flexion, IR and adduction

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20
Q

What are possible causes of gluteus medius tendinosis/tendinopathy?

A

friction
alteration in gait
repetitive microtrauma

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21
Q

GT bursitis may result from _

A

GT bursitis may result from tendinitis

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22
Q

Ischial bursitis becomes painful and inflamed with _ _

A

excessive friction

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23
Q

Is the ischial tuberosity point tender with ischial bursitis

A

yes

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24
Q

Ischial bursitis is painful with A/PROM into _ and _

A

hip flexion - stretches it

hip extension - squeezes it

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25
Q

What is iliopsoas bursitis most likely caused by?

A

repetitive hip flexion (running uphill)

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26
Q

Ilipsoas bursitis may refer to _ and _ dermatome

a. L2 and L3
b. L1 and L2
c. L3 and L4
d. L5 and S1

A

L2 and L3

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27
Q

iliopsoas bursitis will produce pain with AROM

A

hip flexion and extension

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28
Q

iliopsoas bursitis will produce pain with PROM

A

hip extension

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29
Q

patients with iliopsoas bursitis may have tight

A

iliopsoas and rectus femoris

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30
Q

A contusion of the greater trochanter, iliac crest or ASIS from direct blow or landing on the hip

A

hip pointer

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31
Q

Hip pointer will have painful AROM

A

contralateral trunk side bending

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32
Q

Hip pointer will have painful PROM with

A

hip adduction, flexion (same side)

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33
Q

This is defined as spasm/hypertrophy of piriformis compresses “sciatic” nerve

A

piriformis syndrome

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34
Q

What are the potential causes of piriformis syndrome?

A

compression of the sciatic nerve
muscle imbalances
trauma
strain or overuse

35
Q

Patient describes buttock pain that progressed to posterior thigh and calf pain

A

piriformis syndrome

36
Q

What aggravates piriformis syndrome?

A

walking
extended sitting
external rotation of the hip

37
Q

Standing with the lower extremity _ will take out the piriformis

38
Q

AROM with piriformis syndrome

A

SLR and hip ER cause pain

39
Q

PROM with piriformis syndrome that causes pain

40
Q

Palpable tenderness in piriformis (true/false)

41
Q

A micro tear, inflammation, pain with contraction and stretch, local pain is defined as

a. 1st degree muscle strain
b. 2nd degree muscle strain
c. 3rd degree muscle strain
d. none of the above

A

1st degree muscle strain

42
Q

A macro tear, local pain and swelling followed by ecchymosis, spasm, pain with contraction and stretch is defined as

a. 1st degree muscle strain
b. 2nd degree muscle strain
c. 3rd degree muscle strain
d. none of the above

A

2nd degree muscle strain

43
Q

A complete tear, palpable defect, severe pain, bruising, loss of function, and strength is defined as

a. 1st degree muscle strain
b. 2nd degree muscle strain
c. 3rd degree muscle strain
d. none of the above

A

3rd degree muscle strain

44
Q

Muscle strains are typically associated with

A

dynamic overload to eccentric contractions

45
Q

What is seen with muscle strains and AROM?

A

limited ROM, pain with contraction and stretching

46
Q

What is seen with muscle strains and PROM?

A

pain with stretching muscle

47
Q

Palpation with muscle strain

A

tenderness, possible defect

48
Q

How should an acute muscle strain be treated?

A

rest, anti-inflammatory agents, physical agents, e-stim

49
Q

How should sub-acute muscle strain be treated?

A

US, STM, gentle stretching

50
Q

How should chronic muscle strains be treated?

A

STM, progressive strengthening, aggressive stretching, correction of muscle imbalances, gait retraining, functional training

51
Q

Which type of strain is often a recurring problem?

52
Q

This type of muscle strain happens with eccentric load to muscle

a. quad strain
b. HS strain
c. adductor strain
d. hip flexor strain

53
Q

What needs to be addressed with a HS strain?

A

scar tissue

restoring elasticity and ballistic contractions

54
Q

What is secondary to swelling with a HS strain?

A

neural tendon

eventual scar tissue near the sciatic nerve

55
Q

This type of disorder is motion-related clinical disorder

a. FAI syndrome
b. HS strain
c. labral tears
d. quad strain

A

FAI syndrome

56
Q

Symptoms of this disorder include motion-related or position-related pain in the hip or groin, pain in the back, butt, thigh, lateral hip or knee and potential clicking, catching, locking or stiffness

a. FAI syndrome
b. HS strain
c. labral tears
d. quad strain

A

FAI syndrome

57
Q

Patients with this disorder describe pain with clicking, locking, stiffness and restricted ROM giving way

a. FAI syndrome
b. HS strain
c. labral tears
d. quad strain

A

FAI syndrome

58
Q

What is the most commonly used clinical test for FAI syndrome?

59
Q

Patients are typically limited in what motions with FAI syndrome?

A

internal rotation with flexion

60
Q

What causes FAI syndrome?

A

acetabulum and/or femoral head do not develop correctly

61
Q

A patient presents with groin pain and or pinching sensation, pain in the posterior/lateral hip and C-sign, their symptoms line up with

a. HS strain
b. OA
c. muscle strain
d. FAI

62
Q

What does imaging of the FAI look for?

A

cam morphology

pincher morphology

63
Q

flattening or convexity at the femoral head/neck junction

a. cam morphology
b. pincher morphology
c. labral tear
d. FAI

A

cam morphology

64
Q

global or focal over-coverage of the femoral head by the acetabulum

a. cam morphology
b. pincher morphology
c. labral tear
d. FAI

A

pincher morphology

65
Q

both cam and pincher morphology can be present in patients with

66
Q

presence of cam or pincher morphology without symptoms and signs is not FAI syndrome (true/false)

67
Q

Rehab care for FAI goal

A

improving hip stability
neuromuscular control
strength
ROM and movement patterns

68
Q

labrum deepens the socket adding _ to the hip joint as well as _ to the joint itself

A

stability

cushioning

69
Q

What are ways the labral ligament can be torn?

A

degenerative

traumatic

70
Q

This type of labral tear is due to repetitive minor injuries and are often associated with arthritis of the hip

A

degenerative labral tear

71
Q

This type of labral tear can occur with rapid hip motion or sudden stops and turns

A

traumatic labral tear

72
Q

Where is pain usually located with a labral tear?

a. outer hip
b. medial and anterior hip
c. lateral and posterior hip
d. inner hip or groin area

A

inner hip or groin area

73
Q

This injury has a catching sensation within the joint and little to no pain during normal daily activities

A

labral tear

74
Q

Labral tear indicates tenderness with

a. ER and flexion
b. IR and extension
c. abduction and flexion
d. adduction and IR

A

IR and extension

75
Q

What motion reproduces catching sensation in a labral tear?

a. flex and adduction
b. IR and adduction
c. flex and abduction
d. ER and adduction

A

flex and abduction

76
Q

Which test reproduces the clicking sensation with a labral tear?

A

thomas test

77
Q

Pain with labral tear shown in what ROM?

A

flexion and adduction

78
Q

What are the functional tests for the hip and pelvis?

A

deep squat
cross leg sitting
stair ambulation
single leg stand

79
Q

Deep squat functional test is looking for

a. ability to get knees over toes
b. ability to bend knees and pelvis
c. ability to complete with the symmetrical movement of hips and knees
d. ability to get hips down far enough

A

ability to complete with the symmetrical movement of hips and knees

80
Q

Cross leg sitting functional test is looking for

a. ability to cross one leg over the other
b. ability to cross both legs criss cross applesauce
c. ability to place lateral malleolus and distal leg on the opposite anterior distal thigh
d. none of the above

A

ability to place lateral malleolus and distal leg on the opposite anterior distal thigh

81
Q

Stair ambulation for a functional test requires

a. ability to ascend stairs
b. ability to descend stairs
c. ability to ascend and descend 6” stairs
d. ability to ascend and descend 8-12” stairs

A

ability to ascend and descend 8-12” stairs

82
Q

Single leg stand functional test is looking at the

A

assessment of proprioceptive abilities
kinesthetic awareness and control
balancing abilities
reproduction of SIJ symptoms

83
Q

What 3 tests would indicate a labral tear if they are positive?

A

clicking in the hip
IR-flexion-compression
thomas test

MS II (17 decks)

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