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Orthopaedics System > Hip Disorders > Flashcards

Hip Disorders Flashcards

1
Q

define avascular necrosis of the hip (AVN)

A

occurs when there is limited blood supply to the bone (femoral head)

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2
Q

risk factors of necrosis of the hip

A

alcoholism
steroid use
immunosuppression
sickle cell anaemia

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3
Q

clinical features of necrosis of the hip

A

insidious onset of the pain
⬇️ ROM (internal rotation)
stiffness of joint
limp

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4
Q

investigations of necrosis of the hip

A

MRI

XR

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5
Q

conservative management of necrosis of the hip

A

⬇️ weight bearing
physiotherapy
analgesic relief (e.g. NSAIDs)
biphosphonates

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6
Q

surgical management of necrosis of the hip

A

early stages:
- core decompression

late stages:

  • total hip replacement
  • hip joint effusion (younger males)
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7
Q

define femoroacetabular impingement (FIA)

A

an orthopaedic condition in which extra bones grow along either one or both bones of the hip joint causing pain and damage to the joint

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8
Q

types of FIA

A

cam impingement:
associated with SUFE
causes loss of femoral head roundness
seen as concavity of femoral head on XR

pincer impingement:
occurs due to extra bone extending out acetabulum rim
causes crushing of prominent acetabulum rim

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9
Q

clinical features of FIA

A

groin pain that:
worsens on flexion
worsens on standing from seated position
worsens on squatting and lunging

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10
Q

examination findings in FIA

A

replication of pain on FADIR test

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11
Q

investigations for FIA

A

CT scan
XR
MRI

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12
Q

non-operative management for FIA

A

activity modification
analgesic relief
physiotherapy

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13
Q

operative management for FIA

A 
arthroscopy 
open surgery (mainly in men)
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14
Q

define trochanteric bursitis

A

an inflammation of the bursa overlying the greater trochanter of the femur

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15
Q

causes of trochanteric bursitis

A 
soft tissue trauma 
strain injuries 
leg length differences 
prolonged sitting 
excessive running
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16
Q

clinical features of trochanteric bursitis

A

lateral hip pain that worsens at night and is aggravated by physical activity
swelling of the area
+ve Trendelenberg test

17
Q

examination findings of trochanteric bursitis

A

point tenderness
+ve Trendelenberg test
antalgic gait
pain on restricted active abduction or passive adduction

18
Q

investigations of trochanteric bursitis

A

gold: US of hip
XR
MRI

19
Q

initial non-operative management of trochanteric bursitis

A

rest and avoidance of activity
application of ice packs
analgesic relief

20
Q

medical non-operative management of trochanteric bursitis

A

peri-trochanteric corticosteroid injections

physiotherapy (ITB stretch and glute strength)

21
Q

operative management of trochanteric bursitis

A

bursectomy - as a last resort in selected cases

22
Q

define an intracapsular hip fracture

A

fracture involving the femoral neck between the edge of the femoral head and insertion of capsule of hip joint

23
Q

define an extracapsular hip fracture

A

fracture occurring distal to insertion of the capsule either involving or between trochanters

24
Q

describe Garden I and II classification

A

I: undisplaced + incomplete fracture
II: undisplaced + complete fracture

25
Q

describe Garden III and IV

A

III: partial displacement and complete fracture
IV: total displacement and complete fracture

26
Q

clinical features of a hip fracture

A

pain within outer upper thigh or groin that can radiate to the knee
inability to weight bear
shortened, abducted and externally rotated leg

27
Q

investigations of a hip fracture

A

bloods (FBC, U+E and cross-match)

AP and lateral hip XR

28
Q

management of Garden I + II intracapsular fractures

A

internal fixation (with screws)

29
Q

management of Garden III + IV fractures in those < 55yrs

A

internal fixation (with screws)

30
Q

management of Garden III + IV fractures in those >75yrs

A

hemi-arthroplasty

31
Q

management of Garden III + IV fractures in those between 55 - 75yrs

A

total hip replacement

32
Q

management of intertrochanteric extracapsular fracture

A

ORIF with dynamic hip screw

33
Q

management of subtrochanteric extracapsular fracture

A

intramedullary nail

Orthopaedics System (9 decks)

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