Hip Clinical Presentations Flashcards
what are the 2009 ACPM recommendations for osteoporosis?
- Screening for risk factors among individuals > 50 yo
- BMD testing for females ≥ 65 yo and males ≥ 70 yo
- Younger post-menopausal women and men aged 50-69 with 1 major or 2 minor risk factors
at least 90% of hip fractures are sustained by individuals in what age range?
> 65 yo
surgery within how many hours of sustaining a hip fx is considered a positive prognostic indicator?
48 hrs
what are 5 negative prognostic indicators with hip fx? (hint: “a mini male ate 2 ants”)
- male
- over 86 yo
- 2+ comorbidities
- anemia
- mini mental test score ≤ 6/10
prognosis of hip fx is based on what 5 things?
- Displaced vs non-displaced
- Comminution
- Vascular integrity
- Reduction
- Fixation
people who sustain a hip fx are at high risk for what?
thrombosis/embolism
what should you look out for with a femoral neck fx?
AVN and non-union
which type of femoral neck fx is more stable: compression fx or tension fx?
compression
where is severe pain likely to be located after a hip fx?
groin and anterior thigh
what age group is most at-risk for AVN of the femoral head?
30-50 yo
what symptoms are associated with AVN of the femoral head?
- deep groin/anterior hip pain
- buttock pain
- knee pain
why is knee pain associated with AVN of the femoral head?
obturator nerve referral to medial knee
what motion is especially painful in someone with AVN of the femoral head?
IR
what are 3 prognostic indicators for AVN of the femoral head?
- extent of lesion
- location
- bone marrow edema presence
what are 5 common symptoms of hip OA?
- buttock/groin/thigh/knee pain
- “C-sign”
- hip stiffness (greater following prolonged sitting/inactivity)
- difficulty with donning pants, socks, shoes
- stair ambulation limitations
what 3 motions are especially painful for someone with hip OA?
IR, flexion, ABD
does resistive testing typically hurt more or less than AROM/PROM in someone with hip OA?
less
list the CPR for hip OA
- Self-report squatting as aggravating activity
- Lateral pain with active hip flexion
- Passive hip IR ≤ 25deg
- Pain with active hip extension
- (+) Scour test with ADD
what symptoms are associated with FAI?
- Sharp, deep anterior hip/groin pain
- Pain/limitation with deep squat, cutting, lateral movements, painful ER
what risk factors are associated with loose bodies? (hint: your CAPP is loose)
- Chronic hip pain
- Advanced OA
- Prior traumatic hip dislocation (posteriorly)
- Prior AVN
what symptoms are associated with loose bodies?
- Anterior hip/groin pain (deep)
- Catching, locking, clicking, giving way of LE
- Sudden pain with WB activities
what are some activities that can aggravate someone with external snapping hip/IT band friction syndrome?
- Running on slanting surfaces
- Directional change on planted LE
- Laying on ipsi or contra side
what gait deviation is commonly seen with muscle strain at the hip?
antalgic gait
what are 3 risk factors for a hamstring strain?
- prior hx
- hamstring weakness
- older athlete
what are 2 common MOIs for a hamstring strain?
- sprinting with trunk flexion
- fast running
what are 2 risk factors for hip adductor strain?
- prior hx
- dec hip ABD ROM
what is a common MOI for hip adductor strain?
directional change while running
what 2 sports have been clinically correlated with hip adductor strains?
soccer and hockey
what is a common MOI for iliopsoas strain?
forced hip extension during active hip flexion
what are 4 risk factors for quad strain?
- older athletes
- dry playing field
- shorter height
- dominant LE strength/flexibility
what are 2 common MOIs for quad strain?
- Kicking while running, esp if toe gets caught (ex. soccer player)
- Sprinting (during acceleration and deceleration)
what hx is associated with glute med/min strain?
- Fall (often on side and cause forced ADD)
- Increased duration/frequency of loading (i.e. long distance running)
- Sports-related injury
- Middle-aged women
what age range is at greater risk of trochanteric bursitis?
40-60 yo
what is the criteria for diagnosis of trochanteric bursitis? (hint: “LT PPP”)
- Lateral hip pain
- TTP about the greater troch
- Pain at end range rotation, ABD, or ADD (esp positive FABER)
- Pain with resisted hip ABD
- Pseudoradiculopathy
what 3 motions will be painful/limited in someone with iliopsoas/iliopectineal bursitis?
flexion, extension, ER
what hx is associated with GTPS?
- Female gender
- Obesity
- LBP
- Chronic arthropathy of hip/knee
- Middle-age to older adults
what symptoms are associated with GTPS?
- Pain greater at night
- Aggravated with standing ≥ 15 min
- Radiating symptoms (paresthesia, pain, etc)
- Limitation/pain with donning/doffing socks/shoes
- Symptoms typically radiate to mid thigh or at the knee, but may go past knee
what structures are commonly involved in avulsion fractures?
- ischial tuberosity
- AIIS
- ASIS
- pubic symphysis
- iliac crest
- lesser and greater trochanters
what hx is associated with stress fractures?
- female gender
- amenorrhea
- change in exercise program/training intensity
- smoking
- prolonged oral steroid use
