Hip: DDx 1 Flashcards
SCFE aka
epiphysiolysis
Patients between the ages of 4-10 display the highest incidence of these hip conditions
- LCPD
- transient synovitis
- JRA
Articular osteochondritis dessicans is most common between this age range
15-25
Ischemic femoral necrosis is most common in this age range
35-50
Synovial osteochondromatosis usually emerges between this age range
35-50
Hip labral lesions are most common in this age range
18-40
Ages: labral cysts
> 40
Ages: sacral pathologies
> 40
Ages: stress fx of femur and/or pelvis
> 40
Labral cysts, sacral pathologies, and stress fractures of the femur and/or pelvis occur > 40 years old, especially in (males/females)
males
Who is at greatest risk for proximal femoral stress fractures?
young athletic females
Why are young, athletic females at greatest risk for proximal femoral fractures?
female athlete triad
Hip red flags: age
< 20 or > 50
Hip red flags: systemic signs or symptoms consistent with infection or malignancy
- cachexia
- fever
- night sweats
- other constitutional symptoms
Primary bone tumors affecting the pelvis: predominantly (benign/malignant)
malignant
Primary bone tumors affecting the pelvis: most to least frequent
- Chondrosarcoma
- Ewing sarcoma
- Osteosarcoma
- Fibrosarcoma
- Langerhans cell histiocytosis
Primary bone tumors affecting the pelvis: benign
- aneurysmal bone cyst
- fibrous dysplasia
- etc
Primary bone tumors affecting the proximal femur: predominantly (benign/malignant)
benign
Primary bone tumors affecting the proximal femur: most to least frequency
- Fibrous dysplasia
- Solitary bone cysts
- Osteoid osteoma
- Chondroblastoma
Primary bone tumors affecting the proximal femur: malignant
- giant cell tumors
- osteochondroma
etc
OA: (%) of people > 55 have hip OA
68%
OA: These factors lead to pain and limited mobility in the hip (within the bone/capsule)
- loss of articular cartilage
- subchondral sclerosis
- formation of osteophytes
Hip OA: effects within the capsule
- decreased joint capsule motion
- increased intra-articular pressure
Hip OA: signs and symptoms
- insidious onset, first with WB
- joint crepitus
- gluteal atrophy
- ROM may be limited in capsular pattern
- may be obese
- radiographic signs likely degenerative
Hip OA: interventions
- activity modification
- use of AD
- weight reduction
- function/gait/balance
- manual therapy
- exercise
- THA or hemiarthroplasty
CPR for hip OA: 4/5 present = (%) probability
91%
CPR for hip OA: 3/5 present = (%) probability
68%
CPR for hip OA
- squatting reported as aggravating
- scour test with adduction causes groin or lateral hip pain
- AROM hip flexion causes lateral hip pain
- AROM hip ext causes hip pain
PROM hip IR < 25˚
Hip OA: clinical + radiographic classification
hip pain AND at least 2 of 3 of the following:
- ESR < 20 mm/hr
- femoral/acetabular osteophytes
- joint space narrowing
