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MSK 2 > Hip Clinical Presentations > Flashcards

Hip Clinical Presentations Flashcards

1
Q

what are the 2009 ACPM recommendations for osteoporosis?

A
  • 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
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2
Q

at least 90% of hip fractures are sustained by individuals in what age range?

A

> 65 yo

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3
Q

surgery within how many hours of sustaining a hip fx is considered a positive prognostic indicator?

A

48 hrs

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4
Q

what are 5 negative prognostic indicators with hip fx? (hint: “a mini male ate 2 ants”)

A
  • male
  • over 86 yo
  • 2+ comorbidities
  • anemia
  • mini mental test score ≤ 6/10
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5
Q

prognosis of hip fx is based on what 5 things?

A
  • Displaced vs non-displaced
  • Comminution
  • Vascular integrity
  • Reduction
  • Fixation
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6
Q

people who sustain a hip fx are at high risk for what?

A

thrombosis/embolism

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7
Q

what should you look out for with a femoral neck fx?

A

AVN and non-union

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8
Q

which type of femoral neck fx is more stable: compression fx or tension fx?

A

compression

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9
Q

where is severe pain likely to be located after a hip fx?

A

groin and anterior thigh

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10
Q

what age group is most at-risk for AVN of the femoral head?

A

30-50 yo

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11
Q

what symptoms are associated with AVN of the femoral head?

A
  • deep groin/anterior hip pain
  • buttock pain
  • knee pain
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12
Q

why is knee pain associated with AVN of the femoral head?

A

obturator nerve referral to medial knee

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13
Q

what motion is especially painful in someone with AVN of the femoral head?

A

IR

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14
Q

what are 3 prognostic indicators for AVN of the femoral head?

A
  • extent of lesion
  • location
  • bone marrow edema presence
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15
Q

what are 5 common symptoms of hip OA?

A
  • buttock/groin/thigh/knee pain
  • “C-sign”
  • hip stiffness (greater following prolonged sitting/inactivity)
  • difficulty with donning pants, socks, shoes
  • stair ambulation limitations
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16
Q

what 3 motions are especially painful for someone with hip OA?

A

IR, flexion, ABD

17
Q

does resistive testing typically hurt more or less than AROM/PROM in someone with hip OA?

A

less

18
Q

list the CPR for hip OA

A
  • 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
19
Q

what symptoms are associated with FAI?

A
  • Sharp, deep anterior hip/groin pain

- Pain/limitation with deep squat, cutting, lateral movements, painful ER

20
Q

what risk factors are associated with loose bodies? (hint: your CAPP is loose)

A
  • Chronic hip pain
  • Advanced OA
  • Prior traumatic hip dislocation (posteriorly)
  • Prior AVN
21
Q

what symptoms are associated with loose bodies?

A
  • Anterior hip/groin pain (deep)
  • Catching, locking, clicking, giving way of LE
  • Sudden pain with WB activities
22
Q

what are some activities that can aggravate someone with external snapping hip/IT band friction syndrome?

A
  • Running on slanting surfaces
  • Directional change on planted LE
  • Laying on ipsi or contra side
23
Q

what gait deviation is commonly seen with muscle strain at the hip?

A

antalgic gait

24
Q

what are 3 risk factors for a hamstring strain?

A
  • prior hx
  • hamstring weakness
  • older athlete
25
Q

what are 2 common MOIs for a hamstring strain?

A
  • sprinting with trunk flexion

- fast running

26
Q

what are 2 risk factors for hip adductor strain?

A
  • prior hx

- dec hip ABD ROM

27
Q

what is a common MOI for hip adductor strain?

A

directional change while running

28
Q

what 2 sports have been clinically correlated with hip adductor strains?

A

soccer and hockey

29
Q

what is a common MOI for iliopsoas strain?

A

forced hip extension during active hip flexion

30
Q

what are 4 risk factors for quad strain?

A
  • older athletes
  • dry playing field
  • shorter height
  • dominant LE strength/flexibility
31
Q

what are 2 common MOIs for quad strain?

A
  • Kicking while running, esp if toe gets caught (ex. soccer player)
  • Sprinting (during acceleration and deceleration)
32
Q

what hx is associated with glute med/min strain?

A
  • Fall (often on side and cause forced ADD)
  • Increased duration/frequency of loading (i.e. long distance running)
  • Sports-related injury
  • Middle-aged women
33
Q

what age range is at greater risk of trochanteric bursitis?

A

40-60 yo

34
Q

what is the criteria for diagnosis of trochanteric bursitis? (hint: “LT PPP”)

A
  • 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
35
Q

what 3 motions will be painful/limited in someone with iliopsoas/iliopectineal bursitis?

A

flexion, extension, ER

36
Q

what hx is associated with GTPS?

A
  • Female gender
  • Obesity
  • LBP
  • Chronic arthropathy of hip/knee
  • Middle-age to older adults
37
Q

what symptoms are associated with GTPS?

A
  • 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
38
Q

what structures are commonly involved in avulsion fractures?

A
  • ischial tuberosity
  • AIIS
  • ASIS
  • pubic symphysis
  • iliac crest
  • lesser and greater trochanters
39
Q

what hx is associated with stress fractures?

A
  • female gender
  • amenorrhea
  • change in exercise program/training intensity
  • smoking
  • prolonged oral steroid use

MSK 2 (2 decks)

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