Hip: DDx 1

Question 1

SCFE aka

Answer 1

epiphysiolysis

Question 2

Patients between the ages of 4-10 display the highest incidence of these hip conditions

Answer 2

• LCPD
• transient synovitis
• JRA

Question 3

Articular osteochondritis dessicans is most common between this age range

Answer 3

15-25

Question 4

Ischemic femoral necrosis is most common in this age range

Answer 4

35-50

Question 5

Synovial osteochondromatosis usually emerges between this age range

Answer 5

35-50

Question 6

Hip labral lesions are most common in this age range

Answer 6

18-40

Question 7

Ages: labral cysts

Answer 7

> 40

Question 8

Ages: sacral pathologies

Answer 8

> 40

Question 9

Ages: stress fx of femur and/or pelvis

Answer 9

> 40

Question 10

Labral cysts, sacral pathologies, and stress fractures of the femur and/or pelvis occur > 40 years old, especially in (males/females)

Answer 10

males

Question 11

Who is at greatest risk for proximal femoral stress fractures?

Answer 11

young athletic females

Question 12

Why are young, athletic females at greatest risk for proximal femoral fractures?

Answer 12

female athlete triad

Question 13

Hip red flags: age

Answer 13

< 20 or > 50

Question 14

Hip red flags: systemic signs or symptoms consistent with infection or malignancy

Answer 14

• cachexia
• fever
• night sweats
• other constitutional symptoms

Question 15

Primary bone tumors affecting the pelvis: predominantly (benign/malignant)

Answer 15

malignant

Question 16

Primary bone tumors affecting the pelvis: most to least frequent

Answer 16

1. Chondrosarcoma
2. Ewing sarcoma
3. Osteosarcoma
4. Fibrosarcoma
5. Langerhans cell histiocytosis

Question 17

Primary bone tumors affecting the pelvis: benign

Answer 17

• aneurysmal bone cyst
• fibrous dysplasia
• etc

Question 18

Primary bone tumors affecting the proximal femur: predominantly (benign/malignant)

Answer 18

benign

Question 19

Primary bone tumors affecting the proximal femur: most to least frequency

Answer 19

1. Fibrous dysplasia
2. Solitary bone cysts
3. Osteoid osteoma
4. Chondroblastoma

Question 20

Primary bone tumors affecting the proximal femur: malignant

Answer 20

• giant cell tumors
• osteochondroma
  etc

Question 21

OA: (%) of people > 55 have hip OA

Answer 21

68%

Question 22

OA: These factors lead to pain and limited mobility in the hip (within the bone/capsule)

Answer 22

• loss of articular cartilage
• subchondral sclerosis
• formation of osteophytes

Question 23

Hip OA: effects within the capsule

Answer 23

• decreased joint capsule motion

- increased intra-articular pressure

Question 24

Hip OA: signs and symptoms

Answer 24

• insidious onset, first with WB
• joint crepitus
• gluteal atrophy
• ROM may be limited in capsular pattern
• may be obese
• radiographic signs likely degenerative

Question 25

Hip OA: interventions

Answer 25

• activity modification
• use of AD
• weight reduction
• function/gait/balance
• manual therapy
• exercise
• THA or hemiarthroplasty

Question 26

CPR for hip OA: 4/5 present = (%) probability

Answer 26

91%

Question 27

CPR for hip OA: 3/5 present = (%) probability

Answer 27

68%

Question 28

CPR for hip OA

Answer 28

• 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˚

Question 29

Hip OA: clinical + radiographic classification

Answer 29

hip pain AND at least 2 of 3 of the following:

• ESR < 20 mm/hr
• femoral/acetabular osteophytes
• joint space narrowing