Hip: DDx 3 Flashcards
snapping hip syndrome aka
coxa saltans
snapping hip syndrome: (intra/extra)articular
can be classified as intra-articular or extra-articular
cause of intra-articular snapping hip syndrome
snapping of ILIOPSOAS tendon over the ILIOPECTINEAL EMINENCE
extra-articular snapping hip syndrome related to thickening of the
- iliotibial tract at the greater trochanter
- iliopsoas at the pectin pubis
- proximal hamstring at ischial tuberosity
extra-articular snapping hip syndrome related to fibrosis of
gluteus maximus in the posterior hip
extra-articular snapping hip syndrome related to bursa?
adventitious bursal formations
snapping hip syndrome: strengthening focused at improving…
abduction
extension
ER
snapping hip syndrome: focus on normalizing
atypical movement patterns
snapping hip syndrome: what should be avoided in early stages of treatment?
avoid aggravating and overloading activities
snapping hip syndrome: what does the literature say for treating internal/external snapping hip syndrome
lack of good quality literature…
snapping hip syndrome: should improve ROM at the hip as well as looking (where) for regional interdependence contributions to dysfunction
lumbar spine
FAI: CAM lesions common in pts with a hx of
- SCFE
- LCP
- anteversion
- coxa vara
non spherical femoral head causes damage to labrum during hip movement
CAM lesion
FAI: pincer lesions common in pts with hx of
- acetabular retroversion/protrusion
- coxa profunda
FAI: commonly have CAM/pincer
mixture of CAM and pincer
FAI: interventions (generalized)
- education
- joint unloading
- HVLAT
- change in seat
- AD
- injections
- surgery
Labral tears can be a result of
- microtrauma
- macrotrauma
- degeneration related to dysplasia
- developmental deficiencies
Hip labral tears: TRAUMATIC lesions can account for approximately (%) of all lesions
46%
Hip labral tears: DEGENERATIVE lesions can account for approximately (%) of all lesions (including pre-arthritic and dysplastic conditions)
49%
Hip labral tears: CONGENITAL lesions can account for approximately (%) of all lesions
5%
Hip labral tears: patient reported symptoms
increased pain with
sitting
climbing stairs
Hip labral tears: may have these symptoms with WB activities
- clicking
- locking
- giving way
Hip labral tears: pain location
- groin
- buttock
- trochanteric region
(or any possible combination of these areas)
Hip labral tears: ROM assessment
pain and possible limitation during
PROM with the hip flexed
no limitation with the hips extended
loose body in the hip: labral tears can lead to what type of pattern limitation in the hip
noncapsular pattern limitation
A noncapsular pattern of limitation can often be a cardinal feature of
articular loose body
loose body in the hip: noncapsular pattern often accompanied by
- pathological endfeel
- sharp shooting pain with feeling of giving way that immediately follows pain
loose body in the hip: what can cause this?
- acute trauma
- osteochondritis dessicans
- synovial osteochondromatosis
- villonodular synovitis
- flake fracture
- OA
loose body in the hip: gold standard for dx
hip arthroscopy
loose body in the hip: imaging
CT and plain films frequently underestimate prevalence
loose body in the hip: clinically, patients suffering from loose bodies often present with a limit and altered endfeel during these passive motions
adduction and/or ER
