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Musculoskeletal Care > Hip Dx and Txment > Flashcards

Hip Dx and Txment Flashcards

1
Q

what is CC of true hip pain?

A

groin

  • sometimes buttock
  • anterior thigh to knee
  • C sign (captain morgan sign)
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2
Q

what is different from lumbar spine vs hip pain?

A

spine is difficult to reproduce with exam

hip is reproducible with palpation and motion

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3
Q

where does sacroiliac or lumbar spine pain present?

A

posterior thigh

buttock

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4
Q

where does bony pelvis pain present?

A

pain in groin
lateral thigh
anterior thigh

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5
Q

what is a thomas test?

A

opposite hip flexed, observe for amount of flexion affected hip attains
observe for hip flexion contracture

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6
Q

FABER test is good to test for what?

A

hip joint pathology or sacroiliac pathology

pain is a positive sign

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7
Q

when would you see a dislocation of the hip?

A

high energy trauma
MVA
fall
Most are posterior

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8
Q

what is the clinical presentation of hip dislocation?

A

severe pain

inability to move

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9
Q

what are the sequelae of hip dislocation?

A

avascular necrosis of femoral head
sciatic or femoral nerve palsy
chondral defects (early onset arthritis),
labral tears

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10
Q

how do you treat hip dislocation?

A
  1. ER
  2. conscious sedation to reduce
  3. films to evaluate joint
  4. WBAT w/assistance
  5. PT
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11
Q

what are sequelae of femoral shaft fx?

A

fat embolism!!!!!
vessel or nerve injury
compartment syndrome

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12
Q

what is the txment for femoral shaft fx?

A

ER
traction
splinting
usu. requires surgical intervention

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13
Q

what should you always think when you see a femoral fx?

A

pathologic fx
tumor
osteomyelitis

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14
Q

who is most likely to get a stable pelvic ring fx?

A

elderly-unilateral pubic rami fx

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15
Q

what is most likely to cause an unstable pelvic ring fx?

A

usu. high energy trauma

ring is broken at two points

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16
Q

how does a pelvic fx present?

A

pain (groin or buttock)
+/- a fall
+/- ambulation

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17
Q

how do you tx pelvic fx?

A

limit WB ambulation
DVT prevention
High energy injury requires surgical intervention (can bleed out)

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18
Q

who mostly fx their proximal femur?

A 
elderly
sedentary lifestyle
smoking
EtOH abuse
dementia
osteoporosis
19
Q

how does a proximal femur fx present?

A 
hx of a fall
non-ambulatory
C-sign
pain refers distal anterior thigh to knee
Pain with any movement of the thigh
20
Q

when will proximal femur fx be worse?

A

with activity

21
Q

what is characteristic of arthritis?

A

morning stiffness with improvement after activity

22
Q

what’s another name for lateral femoral cutaneous nerve syndrome?

A

meralgia paresthetica

23
Q

what is meralgia paresthetica?

A

pain, burning along lateral border of the thigh

no motor involvement (sensory only)

24
Q

who is more susceptible for meralgia paresthetica?

A

obesity
tight clothing
scar tissue
trauma

25
Q

what is the dx test for meralgia paresthetica?

A

EMG/NCV

26
Q

what might cause osteonecrosis of the hip?

A 
clotting
trauma
chronic steroid use
sickle cell
RA
lupus
27
Q

how does osteonecrosis usu. present?

A

b/w 30-50 yo

often bilateral

28
Q

how do you treat AVN?

A

difficult to tx (pain is primary complaint)
Early: protective weight bearing, remove offending agent
Last resort: arthroplasty

29
Q

which test is dx of AVN?

A

MRI (to properly stage)

30
Q

what is a snapping hip?

A

caused by iliotibial band snapping across the greater trochanter

31
Q

what can a snapping hip cause?

A

trochanteric bursitis

32
Q

who is more likely to get a snapping hip?

A

young females

33
Q

what studies do you do for snapping hip?

A

XR and MRI to r/o labral and other joint pathology

34
Q

how do you treat snapping hip?

A

reassurance
PT (stretching)
injection into trochanteric bursa

35
Q

what is a common overuse injury of the hip?

A

strain of the hip

36
Q

how does a hip strain present?

A

pain over injured tissue

pain with resisting action of muscle group

37
Q

how do you treat a hip strain?

A

PT (stretch and strengthen)

38
Q

what might you feel with a thigh strain?

A

a pop

sudden onset of pain during activity

39
Q

where do most muscle strains occur?

A

myoteninous junction

40
Q

how does transient osteoporosis of the hip present?

A

acute onset of pain

common in middle aged men or women in 3rd trimester of pregnancy

41
Q

how do you treat transient osteoporosis?

A

resolves spontaneously

42
Q

how does trochanteric bursitis present?

A

pain over trochanter that refers to lateral thigh or knee
unable to lie on one side
no acute injury

43
Q

how do you treat trochanteric bursitis?

A

PT
NSAIDS
steroid injection

Musculoskeletal Care (15 decks)

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