Hip/Groin Flashcards
What artery should be considered in groin pain?
External iliac artery
Patient complains of thigh discomfort during cycling, only during high intensity. No reproducible pain on testing.
What is a potential red flag diagnosis?
External iliac artery compression
What are the 3 recommendations from the Warwick agreement
- A negative FADIR helps to rule out hip pathology
- imaging should not be used in isolation
- X-rays are useful to aid diagnosis
List red flags for the hip/groin region (7)
- Cancer history
- Visceral referral
- Trauma
- Fever
- Painful urination
- Night pain
- Prolonged steroid use
What is a useful objective measure for ruling out avascular necrosis in the hip/groin?
Hip rom
Two ways to rule out a stress fracture?
- Fulcrum test
- Hop test
True or false: x-ray is useful for a vascular necrosis ?
True
True or false: x-ray is useful for stress # ?
False. Only if really late stage
Is the thigh thrust test sensitive or specific ? Give values
Sensitive - 88%
Pubic-related groin pain is more likely if what objective finding is present?
- Pain on resisted adductor and abdominal testing
Pubic-related groin pain can be treated the same as…….?
ARGP
How do you test the deep neck flexors ?
Craniocervical flexion test
What is an appropriate and evidenced based way to measure RSI and athletic groin pain?
Drop jump RSI
In the study by Baida, with treatment, what was the average RTP time for those with AGP ?
9 +/- 3 weeks
What did Thorborg find in regard to abd/add ratio?
Found no difference between injured and controls
What is the consensus paper for classifying intra-articular groin pain?
Zurich agreement
When measuring pelvic tilt on an x-ray, what’s the normal degree of anterior tilt? Why’s it relevant?
1-3cm
Gives a false picture of acetabular retroversion
What is the more common FAI?
Cam-type
Growth in femoral neck
What alpha angle tends to be more associated with symptoms in FAI and would be considered “large”?
> 78 alpha angle
At what age does the growth plate around the femoral neck close in males?
14-15
At what age does the femoral neck growth generally close in females ?
11-12years
If suspecting hip dysplasia, what x-ray views should you request?
- AP pelvis
- False profile view
Decreased hip IR, increased ER could indicate what?
Acetabular/femoral retroversion
What test MIGHT be useful to for suspected FAI? State whether is sensitive or specific.
Prone IR
Specific
What test MIGHT be useful for suspected labral tear? State whether is sensitive or specific.
Thomas test
Both specific and sensitive
What test MIGHT be useful for suspected ligamentum teres injury? State whether is sensitive or specific.
Ligamentum teres test
Both sensitive and specific
What is a negative result for prone IR test
Normal rom. Can still have pain w/ negative
Increased hip IR and reduced hip ER, could indicate what? And what’s the cut off score for “different” in side to side comparison ?
Anteversion
Greater than 20 degrees difference
According to systematic reviews, what are the most commonly seen impairments in FAI?
- Decreased hip strength
- Bilateral decreased trunk strength
- Decreased hop distance (-9cm)
- Decreased one leg rise (-7cm)
