Hip dysfunctions

Question 1

What is sacroilliac joint dysfunctionn

Answer 1

degenerative condition of sacroilliac joint causing pain-
clinical diagnosis based on worsened pain on hip flexion, adbu and external rotation

most common - idiopathic
but can result from Ankylosis spond
Infection
metabolic causes

RF-trauma to pelvis, pregnancy

Question 2

Sx of sacroilliac joint dysfunction

Answer 2

Pain presenting inferior to PSIS (only 4% above L5)
can radiate down the knee
worse when wearing a belt

Exam-
antalgic gain
Focal tenderness of PSIS
PAIN on hip flex, abduction and externel rotation (FABER test)
make sure to do straight leg test (if caused by nerve root)- should be negative

Ix- recomended pelvis xray, and SI joint view
often see signs of OA

BIG thing are DDX
under 40- AS
cancer of spine (night pain_
cauda equina sx
osteoporisis
Shingsla
Sciatica

Question 3

management of sacroilliac joint dysfunction

Answer 3

Oral NSAIDS
phsysical therapy
pelvic belt can help

if not working- SI joint steroid injections

if not - surgery

Question 4

What is transient synovitis

Answer 4

Irritable hip - acute hip pain following a recent viral infection in a child (most common group) 3-8 y/o

Question 5

Sx and ix of transient synovitis

Answer 5

Sx- limp/inability to weight bear that develops over a few hours/days
doesnt last >3 days
Recent viral infection
Hip pain
otherwise well or v low grade fever
exam- patient well, often sit with leg externally rotated (less painful) but more pain when you straighten leg

always consider scpetic arthiritis if v unwell, more pain, etc

Ix- nada for transient
but if suspicious- consider aspiraion

Question 6

Management of transient synovitis

Answer 6

can be moniotored in 1ary care if non-suspicious
self limiting
self care, rest and analgesia- and tcb after 72h