Hip complaint Flashcards
What is the most common in newborns?
Hip dysplasia
How do you test for hip dysplasia and what are you looking for?
Use the Ortolani and Barlow maneuvers to test for hip dislocation and you may feel or hear a hip clunk when it dislocates
What is common in boys 3-12 yo?
Perthe’s Disease (Legg-Calve-Perthe’s Disease)
What happens with Perthe’s Disease?
The blood supply to the femoral head is interrupted and then femoral head necroses and possibly fractures; it will eventually reform but it will be an odd shape and can result in osteoarthritis
What are the signs and symptoms of Perthe’s Disease?
Limping and stiffness in hip/groin
What is common in obese boys 8-15 yo?
SCFE (Slipped capital femoral epiphysis)
What happens with SCFE?
The growth plate is damaged and the femoral head slips with respect to the rest of the femur - may be associated with a growth spurt
What are the signs and symptoms of SCFE?
Impaired internal rotation = leg rotated outward
What is most common in people 30-50 yo?
AVN - Avascular Necrosis
What is Avascular Necrosis?
Very similar to Perthe’s Disease but in adults; limited blood supply to femoral head causes it to die and fracture
What can also cause avascular necrosis?
Long time alcohol or steroid use
What is more common in middle - aged women, obese, who overuse or injure their hip?
Trochanteric Bursitis
What is Trochanteric Bursitis?
Inflammation of the bursa; symptoms include pain on the outside of hip and pain when walking up stairs or laying on affected side
Describe osteoarthritis of the hip
Most common in people over 60;
Breakdown of cartilage, narrowing joint space, formation of bony spurs
Symptoms = pain after use or inactivity
What is FAI
Femoral Acetabular Impingement
- Hip joint not shaped normally
Athletes, adolescents, adults can have what?
FAI
What is the diagnosis for damage to the cartilage around the hip that results in clicking, locking, catching?
Labral tear
What is most common in white women over 85 yo who FELL?
Hip fracture
What can cause compartment syndrome?
A buildup of pressure within muscles that can be caused by pelvic fractures/crush injuries
What are the signs of compartment syndrome?
5Ps = pain, paresthesia, pallor, paralysis, pulselessness 3As = agitation, anxiety, increased analgesic requirement
What is more common in infants and older adults that includes an infection of the joint?
Septic arthritis - warm, red, swollen
What are the 2 causes of piriformis syndrome?
Piriformis spasms = pain or it spasms and irritates the sciatic nerve = numbness/tingling
ROM for hip flexion?
90
ROM for hip extension?
15-30
ROM for hip ABduction?
45-50
ROM for hip ADDuction?
20-30
ROM for hip internal rotation?
30-40
Describe the setup for hip flexion SD MET
pt prone, physician extends at hip and holds beneath flexed knee to do so, engage RB and then have them flex against you
Describe the setup for hip extension:hamstrings SD MET
pt supine, physician flexes at hip and holds beneath an extended knee, engage RB and then have them extend against you
Describe the setup for hip extension:glutes SD MET
pt lateral recumbant, flex at the top hip, engage RB and have them extend against you
Describe the setup for internally rotated hip SD MET
pt supine, flex at hip and knee
externally rotate to engage RB, have them internally rotate against you
Describe the setup for externally rotated hip SD MET
pt supine, flex at hip and knee
Internally rotate to engage RB, have them externally rotate against you
Describe the setup for hip Abduction SD MET
pt supine, physician stabilizes both ankles and lifts affected side
Engage RB by ADDucting LE and then having them ABduct against you
Describe the setup for hip ADduction SD MET
pt supine, physician stabilizes both legs
Engage RB by ABducting LE and then having them ADDuct against you
