Hip: DDx 6 Flashcards
hip lag sign: used to dx what?
damage to hip abductors
patient positioning for hip lag sign
- sidelying with affected leg on top
- examiner stabilizes pelvis with one hand and positions the other under the hip
- passive extension 10˚
- passive abduction 20˚
- maximal IR
- 45˚ knee ext
hip lag sign: once in start position, what is the pt asked to do?
hold the position actively while the examiner releases the leg
hip lag sign: (+) test
pt unable to keep the leg in the test position and the foot drops more than 10 cm
hip lag sign: sensitivity
Sn = 89%
hip lag sign: specificity
Sp = 95%
ITBS: s/s
- lateral hip, thigh, knee pain
- snapping ITB over greater trochanter
ITBS: onset
gradual onset, overuse
ITBS: special testing
(+) Ober
newer research shows this test may actually be better for hip joint capsule vs. ITB
ITBS: treatment strategies
- activity modification
- address faulty mechanics
- stretching/strengthening exercises
- ice massage
- NSAIDs
- footwear
- lumbar spine
myositis ossificans: development of bone in a muscle as a result of
- trauma
- may also be chronic in nature
myositis ossificans: type of trauma that typically causes
usually a contusion with a hematoma 2-4 weeks prior
myositis ossificans: s/s
- pain on palpation and with muscle movement
- noncapsular pattern
- ecchymosis may or may not be present
myositis ossificans: diagnosis made by
- radiographs
- US
myositis ossificans: treatment
- ice
- NSAIDs
- stretching
- surgery if conservative tx fails (watch for dec ROM and inc pain)
muscle strains: most common types in the hip
- HS
- rectus femoris strain/contusion
- adductor longus
muscle strains: where does RF strain/contusion typically occur within the muscle?
mid-upper 1/3
muscle strains: need to rule this out, especially in repetitive strains
neural irritability
muscle strains: pain with…
- contraction
- stretching
- palpation
muscle strains: treatment
- modalities PRN
- relative rest
- appropriate stretching and strengthening
hip stress fx: typically found where?
- proximal ⅓ of the femur
- femoral neck
- pubic ramus
hip stress fx: pain pattern
- immediate onset of pain on WB
- stops once WB is discontinued
hip stress fx: clinical examination
often completely negative
hip stress fx: clinical examination
symptoms often reproduced with what
SL hop
hip stress fx: symptoms may be reproduced with this test
fulcrum test
hip stress fx: dx can be confirmed via (imaging)
bone scan
MRI
hip stress fx: if impact related, what should be reduced or eliminated
loaded activity - until the fx has healed
hip stress fx: condition is best treated by addressing both
cause and effect
hip stress fx: medical and pharmacological management should be administered to address any underlying condition such as
- OP
- osteomalacia
- malignancy
- metastasis
groin pain: common causes
- sports hernia
- adductor dysfunction
- athletic pubalgia
- osteitis pubis
groin pain often occurs in these types of athletic movements
- quick acceleration
- rapid changes in direction
- kicking
- frequent side to side motion
- twisting at the waist
groin pain: pain in inguinal region may radiate where?
adductors or scrotum/testicles
groin pain: ttp where?
- pubic tubercle
- pubic symphysis
- lower rectus abdominus
- external ring of inguinal canal
groin pain: can also be referral from where?
- lumbar spine
- SIJ
- bowel/bladder issues
- obturator nerve
etc
groin pain exam: testing for rectus tendinopathy and/or sports hernia with what tests?
- resisted sit up/abdominal flexion
- resisted double hip adduction
groin pain exam: test for tendinopathy
- selective tissue tension testing
- specific muscle stretching
groin pain exam: test for pelvic ring dysfunction
ASLR
groin pain exam: test for labral and intra-articular pathology
hip scour
