Hip Conditions Flashcards
AVN of the Hip (oseonecrosis)
- 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
AVN Dx
plain film imaging,
bone scans,
CT or MRI
AVN Medications
- acetominophen for p!
- NSAIDs for inflam
- _**Corticosteriods are contraindicated since they may be a causative factor**_
AVN and PT
- joint/bone protection
- maintain/improve joint mechanics
- aerobic conditioning
- post-surg = regain funx flexibility, improving strength, gait etc
Femoral Ante/Retroversion
- ante version: inward 25-30 deg or more = squinting patella
- retroversion = angle <0 fem neck rotated backward in relation to femoral condyles
Femoral Ante/Retroversion Dx
plain film imaging
(+) Craig’s test
Femoral Ante/Retroversion PT
maintain/improve joint mechanics and connective tissue functions
Coxa Vara and Valga
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
Coxa Vara and Valga Dx
plain imaging
Coxa Vara and Valga PT
maintain/improve joint mechanics and connective tissue functions
Trochanteric Bursitis
- inflammation of deep trochanteric bursa from a
- direct blow,
- irritation of ITB,
- biomechanical micro trauma
- common in pts w/ RA
Trochanteric Bursitis Dx
differentiate from contractile condition by comparing results of AROM, PROM and resistive tests
Trochanteric Bursitis Medications
Acetaminophen
NSAIDs
Trochanteric Bursitis PT
- Flexibility Manual therapy for joint
- Aerobic conditioning
- Thermal agents for p!/edema reduction
- Patient education/funx training
ITB syndrome
Tight ITB or abnormal gait patterns results in inflammation of trochanteric bursa
ITB syndrome Dx
(+) Noble Compression Test
(+) Ober’s Test
ITB syndrome medications
Acetaminphen and NSAIDs
ITB syndrome PT
- reduction of pain and inflammation utilizing modalities, soft tissue, and joint oscillations
- Correction of ms imbalance
- Address biomechanics faults
- gait training
- pt education
Piriformis Syndrome
- 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
Piriformis Syndrome Dx
- pssible electrode tests for sciatic involvement
- biomechanical LE exam to determine cause and r/o SIJ or Lumbar involvement
Piriformis Syndrome Meds
- acetaminophen
- NSAIDs
- neurontin for neuropathic p!
Piriformis Syndrome PT
- 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
