Hip conditions Flashcards
pulled hamstring
sudden exersionof the hamstrings that results in srething of the posterior thigh muscles e,g jumping , sprinting and lunging
sudden tension of the hamstrings results in muscle sprain, a prtial tear or compelte tear at orgin of hamstrings at the ischial tuberosity and can sometimes by accompanied by avulsion of fragment of bone
- osteoarthiris affects what?
- % of surffers and age?
- what is it known as patholgically?
- what is known as clincally?
- is it inflamatory?
- examples of inflammatory diseases?
- primary oA risk factors
- secondary oA risk facos?
- symptoms?
- pathology of OA?
- four cardianal sings of OA on x ray
- synovial membrane
- 30-30% over 70 have OA of hip
- degenrative disorder
- clinical sydnrome comprising joint pain accompanied with functional limitation and reduced quality fo life
- no
- ankylosis (fusionof bones)
- age, female , ethnicity ^ african america, hispanic, native americans), genetics (OA runs families),nutrition ( consumptiosnof antioxidants like VITC and E can offer protection against OA)
- obestiy, boen injury, maligncy, inflammatory arthitis RA, ankylosis spndylitis, haemtological disorderm endocrine abnor.
- deep ching joint, stiffness during rest, redced range of mortion and crepitus
- hyaline cartilage becomes swoleen due to ^ proteilglycans sytnehesis by chondrocytes, then these chondrocytes differentiate into chondroprogentor cells . …. at this stage tryign to repait the cartilage and continue for years, but proteglcan content falls causing cartilage to soften and lose elasticily , flaking and fibrillation can be seen microscoically adn over timecartilage erodes, sos loss of joint space, …these surfaces change in catilage alter the biocehmical forces and trugger some changes , the subchondral bone responds with vacular invasion adnincreased cellularity , beocing thicked adn denser areas of pressure , this known as eburnation and manifests as subcondral sclerois on x rays,
whats seen on an x ray of OA adn describe the pathophysiology of OA
- the cartilage swells due to the increased proteoglycanssythensis by chonrytces, the number of chondrocytes increase and these chondrocytes differentiate into chondroporogentior cells. at tis stage cartiage repair is being done
- ovre time the prto. decrease and so the cartilage looses elasticity and softens, microschopically flaking and fibrillation can be seen on the smooth articular surfaces of catilage. overtime these catialge erodes down to the subchondral one resulting in loss of joint space
- this surfac change causes biochemcal changes to the active tissue, increased cellularity , thickening, vascualr invasion, denser areas of pressure. this known as eburnation, and manifests as subchondral sclerosis on x ray
- traumatised subchondral bone mat also undergo cystic degeneraton toform subchonal bone cysts wc attribute to either osseous necrosis secondary to chronic impaction (pressure) or intrusion of the synovial fluid
- at either side of the arituclar margin osseous metaplasia of the connective tissue occurs, leading to irreualr overgrowth of the new bone - osteophytes
- redued joint space
- subchondrual scleoris
- bone cysts
- osteophytes
oA of hip who is most common on? symptoms? treatment?
- males over 40
- joint stiffness / pain the in hip/ reduced motility/mechanical pain (Accentuated with weight bearing)/crepitus (sounds grating)/pain inthe hip (via the obturator nerve)
- treartment = weight loss, walkigns tick/ musle strneghtening exercises. nti-infammatory NSAIDs, analgesia/ nutrional supplements; (glucosamine, and chondriton sulfate)/ viscosupplementation (injection of hyualnarinc acid into the joint to increase lubricatin)
- hip repalcement ^)% hip replacemnt are women adn average age 67 for men and 69 women
femoral neck fractures
fractoure of promxiaml femur, they arent intracapsualr or extracapsular
intracapuslar = ligamnteres loss, and most common in elderly and post menaosal and osteoportic bone, due to minor fall or road trafffic accident . treatment is surgey (either hemiarthiroplasty - replacemnt of femoral head/ or total hip replacement - hip and acetabulum] this is due to the risk of avasular necrosis]
extracpualsr =reticular arteral aupply maintian (cervical scencding b supply)
symptoms = reuced mobility adn pain in the hip wc spreads to groin and/ knee
how do you examine a hip fracture
affected leg is shrotened, adbucted and externally rotated/ great pain upon palpitating greater trochanter and exacberated with rotationof the hip
why is the hip shortened , adbucted and externlly roated
theshort lateral roators (gemmelu, quf, pri, obinterns) contract and externally roate the femoural shaft.
iliopsoas acts as lateral rotator and pulls the lesser trochanter anteriorly so femoral shaft now externally roated
strong sbductors attatches to greater trochanter (g mediuma dn minimus) abduct the femur distal to teh frature site and also exernally roate the femur
shortening is due tot he thigh muscles pulling the femur fragemtns distally (rectus femrous, adductor magmus adn hamstring)
