Hip Examination Flashcards

1
Q

Percentage of patients with knee OA that have Hip OA

A

40%

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2
Q

WOMAC

A

Lower extremity scale

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3
Q

Harris Hip Score

A

Scored by PT

Pain, Gait, Mobility, Deformity (ROM Loss)

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4
Q

LE Functional Scale

A

20 functional activities

Each rated 0 (Unable to perform) to 4 (No Difficulty)

Sensitive to change–>9 points minimal level of detectable change

Out of 80 points

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5
Q

Pain location of OA in the hip

A

1) Greater Trochanter
2) Anterior Thigh
3) Knee Region
4) Groin

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6
Q

L1 Dermatome Point

A

Inguinal Line

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7
Q

L2 Dermatome Point

A

Anterior Proximal Thigh

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8
Q

L3 Dermatome Point

A

Anterior distal thigh

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9
Q

L4 Dermatome Point

A

Medial distal Leg

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10
Q

L5 Dermatome Point

A

Lateral Leg

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11
Q

S1 Dermatome Point

A

Lateral dorsum of foot

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12
Q

Ward’s Triangle

A

Weak part of neck of femur due to lack of trabeculae

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13
Q

Risks for Osteoporosis

A

Women >65 who weigh less than 140 at menopause or never used estrogens for >6 months

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14
Q

Kellgren Lawrence Radiographic grade

A

Scale of joint space narrowing

Baseline grade is important predictive factor for having a THA

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15
Q

Grade I Kellgren/Lawrence

A

Doubtful narrowing of joint space and possible osteophytic lipping

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16
Q

Grade II Kellgren/Lawrence

A

Definite Osteophytes, definite narrowing of joint space

Strong predictor of hip OA progression

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17
Q

Grade III Kellgren/Lawrence

A

Moderate multiple osteophytes, definite narrowing of joint space, some sclerosis and possible deformity of bony contour

.3 odds ratio of having a THA

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18
Q

Grade IV Kellgren/Lawrence

A

Large osteophytes, marked narrowing of joint space

5.3 odds ratio that pt. would have a THA

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19
Q

Sign of the Buttock

A

Positive is a Red Flag
Straight leg raise equal leg flexed or extended

Possible neoplasm, septic bursitis, sacral fx, ischiogluteal bursititis

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20
Q

GI Red Flags

A

Nausea, vomiting, abdominal pain, changes in bowel function, blood in stool, tests for psoas abscess

21
Q

Vascular Red Flags

A

Throbbing, varicose veins, trophic changes, Hx. of heart disease

22
Q

Infectious Red Flags

A

IBD such as Crohn’s, ulcerative colitis, diverticulitis, appendicitis, recent skin rashes

23
Q

Cancerous

A

Previous hx of cancer, bone night pain, night sweats, palpate the lymph nodes

24
Q

Gait component measures

A

Step length, stride length, fick angle, speed

25
Q

Blind Stance WB

A

pt looks straight ahead and stands on two scales

26
Q

FTPO

A

Only works if pain is abolished when leaning opposite

If pain is abolished when leaning away, lean to until pain

27
Q

LE Alignment

A
Compensated Anteversion: Toe in
Compensated Retroversion: Toe out
Posterior Dislocation: Short/Adducted/IR
Anterior Dislocation: Abducted/ER
Intertrochanteric Fx: Short/ER
28
Q

Weber-Barstow Maneuver

A

pt supine
Hip bridge then drop down
PT pulls legs out
Compare with thumbs on medial malleoli

29
Q

Prone Knee Flexion Test for tibial shortening

A

pt prone
Neutral ankle
Look at level of plantar surface of feet

30
Q

Flexion ROM

A

0-120°

31
Q

Extension ROM

A

0-20°

32
Q

Abduction ROM

A

0-45°

33
Q

Adduction ROM

A

0-30°

34
Q

IR ROM

A

0-45°

60-90° if anteverted

35
Q

ER ROM

A

0-45°

36
Q

Open Pack Position

A

30° flexion
30° abduction
Slight ER

This is a position of bony approximation

37
Q

PROM

A

When AROM isnt full and pain free

38
Q

Hip capsular pattern

A

Limitation in flexion, abduction, and IR

39
Q

3 most commonly limited motions with hip OA

A

IR/ER

Flexion

40
Q

Closed Pack Position

A

Full Extension

Full IR

41
Q

Coxa Saltans Internal Snapping

A

1) Iliopsoas over lesser trochanter or anterior acetabulum
2) Iliofemoral ll over femoral head
Both commonly cause snap at 45 when extending from flexed position

42
Q

Coxa Saltans External Snapping

A

1) ITB over Greater Trochanter
2) Gluteus Maximus over Greater Trochanter
Palpated lateral during hip flexion and extension

43
Q

Coxa Saltans Intra-articular Snapping

A

Acetabular Labral Tear/Loose Body

-Often present with sharp pain in groin and anterior thigh especially with pivoting motions

44
Q

Functional Step Up/Step Down Testing

A

Up with the bad

Down with the good

45
Q

Activity Limitation and Participation Restriction Measures

A

6 minute walk test
Self-Paced Walk Test- 400m walk
Stair Measure- 20 steps on 6 inch block timed
Timed Up and Go Test- Stand walk 3m and back and sit

46
Q

Ortolani’s Test

A

-Infant supine
-Grasp thighs with thumbs medially and fingers laterally at greater trochanter
-Gentle traction, abduction, and med directed pressure on greater trochanter
-Looking for reduction
Valid first 1-3 weeks of birth for dislocated/subluxed hips

47
Q

Causes of Intoeing Gait in Children

A

Femoral Anteversion
Internal tibial torsion
Metatarsus Adductus

48
Q

Children Femoral Anteversion

A

Born with ~40°
2:1 Females to males
Derotational femoral osteotomy at 8-9 y/o

49
Q

Derotational Femoral Osteotomy

A

Femoral anteversion >45°
Absent ER
Functional disability or severe cosmetic deformity