Hip Exam, Eval, Interventions Flashcards
which hip joint dysfunction is suspected in 2-8 yo?
AVN (Legg Perthes)
which hip joint dysfunction is suspected in 10-14 yo?
SCFE
OCD
which hip joint dysfunction is suspected in 14-25 yo?
stress fx
synovitis
FAI
which hip joint dysfunction is suspected in females 50+?
glute med tendinopathy or tear
how is the hip displaced in congenital hip dysplasia?
upward and lateral
appearance of limb with congenital hip dysplasia?
short, flexed, abducted
special tests for congenital hip dysplasia
Galeazzi’s sign
Ortolani’s sign
age for Legg-Calve-Perthes
2-13
appearance of Legg-Calve-Perthes
short limb
higher greater troch
quad atrophy
adductor spasm
age for SCFE
male 10-17
female 8-15
appearance of SCFE
short limb
usually obese
quad atrophy
adductor spasm
pain in extreme motion
hip abducted and ER
what is suspected: antalgic gait after activity (child)
Legg-Calve-Perthes
what is suspected: antalgic gait acutely, Trendelenburg sign and ER chronically
SCFE
which hip dysfunction is urgent and should immediately make the pt NWB?
SCFE
which hip dysfunction requires surgery?
SCFE
what is suspected:
30-50 yo
flattened femoral head
avascular necrosis
list Altman’s clinical criteria for hip OA
hip pain
IR <15 deg
pain in IR
morning stiffness up to 60 mins
age >50 yo
list Sutlive CPR for hip OA
- self-reported squatting aggravates
- Scour test with adduction causes groin or lateral hip pain
- active hip flexion causes lateral pain
- active hip extension causes hip pain
- passive hip IR </= 25 deg
3/5 = 68%; 4/5 = 91% probability
A evidence for hip OA CPR
risk factors
diagnosis/classification
outcome measure
activity limits & participation restrictions
B evidence for hip OA CPR
pathoanatomical features
patient education
manual therapy
flexibility, strength, endurance testing
C evidence for hip OA CPR
functional gait and balance training
E evidence for hip OA CPR
differential diagnosis
which tests rule out labral tears
Scour
FABER
Fitzgerald’s
FABIR
which test rules out SIJ pain
SIJ provocation tests
which test rules out L2-3 radiculopathy
femoral nerve stretch
what should always be ruled out with muscle strains?
neural irritability
what is suspected:
decreased ROM
trauma
hematoma
myositis ossificans (quads)
MOI for ITB syndrome
gradual, overuse
test for ITB syndrome
Ober’s
which nerve is disturbed with meralgia paresthesia?
lateral femoral cutaneous nerve
if reaching down to tie shoes causes pain, ____ is most likely
OA
aggravating factors for glute med tendinopathy/tear
stairs, SLS, sleeping on side
cluster test for glute med tendinopathy/tear
FABER
external de-rotation test
adduction + external de-rotation test
palpation of glute med
stand on effected leg in SLS
glute med tendinopathy/tear must have pain that is _____ & ______
localized and load dependent!!
T/F: diffuse pain with low load indicate tendinosis
F!!!!
in which stages of recovery for glute med tendinopathy/tear is the pt NWB?
stage 1-2
acetabular labral pathologies are common in HIGHLY active people aged _____
20-40 yo
hip OA is highly correlated with _____
labral pathology
cam vs. pincer impingement
cam - femoral head/neck
pincer - acetabular
femoral head ____version and coxa ____ are more susceptible to cam impingement
anteversion
coxa vara
anterio-medial FAI is seen with what positions
flexion and IR passive
posterior FAI is seen with what positions
flexion, abduction, ER (fig. 4)
femoral neck fx will not be able to passively ___ hip
rotate
unique hip subjective questions
h/o LBP
h/o hip probs as child or later in life
h/o clicking, popping, catching
OA related questions (24 hr. pain)
surgical info
which motions does traction manips restore?
ALL
if a hip manip is being done in supine, this is open or closed pack?
open
dosage of ROM exercises
high reps (20s)
which comes first: mobility or stability?
mobility
is open or closed chain exercises easier?
open
common findings in young females that lead to FAI
general ligamentous laxity
hypomobility in lateral & anterior capsule
weakness in hip abductors, ER
poor LE control in closed-chain
when is the highest risk for injury recurrence of hamstring strain?
1st 2 weeks
what type of athletes commonly get hamstring strains?
high-speed skilled movements required
