Hip Conditions

Question 1

AVN of the Hip (oseonecrosis)

Answer 1

• multiple etiologies resulting in an impaired blood supply to the femoral head
• Hip ROM is decreased in Flex, IR, and ABD
• Pain in the groin and/or thigh
• TTP at hip joint
• Coxalgic gait

Question 2

AVN Dx

Answer 2

plain film imaging,

bone scans,

CT or MRI

Question 3

AVN Medications

Answer 3

• acetominophen for p!
• NSAIDs for inflam
• _**Corticosteriods are contraindicated since they may be a causative factor**_

Question 4

AVN and PT

Answer 4

• joint/bone protection
• maintain/improve joint mechanics
• aerobic conditioning
• post-surg = regain funx flexibility, improving strength, gait etc

Question 5

Femoral Ante/Retroversion

Answer 5

• ante version: inward 25-30 deg or more = squinting patella
• retroversion = angle <0 fem neck rotated backward in relation to femoral condyles

Question 6

Femoral Ante/Retroversion Dx

Answer 6

plain film imaging

(+) Craig’s test

Question 7

Femoral Ante/Retroversion PT

Answer 7

maintain/improve joint mechanics and connective tissue functions

Question 8

Coxa Vara and Valga

Answer 8

coxa vara: <115

coxa valga: >125

**may result from necrosis of femoral head occurring with septic arthritis, or coxa vara specifically with defect in ossification

Question 9

Coxa Vara and Valga Dx

Answer 9

plain imaging

Question 10

Coxa Vara and Valga PT

Answer 10

maintain/improve joint mechanics and connective tissue functions

Question 11

Trochanteric Bursitis

Answer 11

• inflammation of deep trochanteric bursa from a
  
  • direct blow,
  • irritation of ITB,
  • biomechanical micro trauma
  • common in pts w/ RA

Question 12

Trochanteric Bursitis Dx

Answer 12

differentiate from contractile condition by comparing results of AROM, PROM and resistive tests

Question 13

Trochanteric Bursitis Medications

Answer 13

Acetaminophen

NSAIDs

Question 14

Trochanteric Bursitis PT

Answer 14

• Flexibility Manual therapy for joint
• Aerobic conditioning
• Thermal agents for p!/edema reduction
• Patient education/funx training

Question 15

ITB syndrome

Answer 15

Tight ITB or abnormal gait patterns results in inflammation of trochanteric bursa

Question 16

ITB syndrome Dx

Answer 16

(+) Noble Compression Test

(+) Ober’s Test

Question 17

ITB syndrome medications

Answer 17

Acetaminphen and NSAIDs

Question 18

ITB syndrome PT

Answer 18

• reduction of pain and inflammation utilizing modalities, soft tissue, and joint oscillations
• Correction of ms imbalance
• Address biomechanics faults
• gait training
• pt education

Question 19

Piriformis Syndrome

Answer 19

• overworked external rotator of the hip w/ excessive overpronation of the foot causing abnormal femoral internal rotation .
• The tonic ms is active with motion of the SIJ
• Tightness/spasm of piriformis can result in compression of sciatic nerve or SIJ dysfunction
• Signs/Symptoms:
  
  • restriction in IR,
  • TTP,
  • referral of p! to post thigh,
  • weakness in ER
  • (+) piriformis test
  • uneven sacral base

Question 20

Piriformis Syndrome Dx

Answer 20

• pssible electrode tests for sciatic involvement
• biomechanical LE exam to determine cause and r/o SIJ or Lumbar involvement

Question 21

Piriformis Syndrome Meds

Answer 21

• acetaminophen
• NSAIDs
• neurontin for neuropathic p!

Question 22

Piriformis Syndrome PT

Answer 22

• Reduction of p! utilizing modalities and manual therapy techniques
• Joint oscillations
• Correct ms imbalance
• Restore ms balance and protection of SIJ
  
  • (step off curb onto dysfunx LE
• Correction of biomechanics faults - orthotics etc