Hip History Flashcards
The Hip History Should Include the following
Patient Age Pain location distribution of symptoms symptom fluctuation motion restrictions mechanism of injury behavior of symptoms aggravating or relieving factors
The Hip History Should Include the following
Patient Age Pain location distribution of symptoms symptom fluctuation motion restrictions mechanism of injury behavior of symptoms aggravating or relieving factors
Why is it important to know the patient’s age
It is useful in diagnostic hypothesis for age related pathologies
At what age Hip OA typically diagnosed?
> 60 although it can occur earlier
What may hip pain in patients <40 indicate?
AVN= avascular necrosis or Stress Fracture
What type of pain presentation suggest hip joint involvement
Groin pain and hip pain during weight bearing suggest hip joint involvement
Where does OA refer pain to
OA may refer pain to anterior thigh, knee or posterior to greater trochanter
What may be an indication of an alternate etiology?
Periarticular pain not reproduced by PROM and palpation suggest alternate etiology (bursitis, tendinitis, periostitis)
What is it important to remember about pain in the Hip area?
That the pain may be referred from the lumbar spine!
What is the C sign?
It is a acharacteristic sign if patient presenting with a hip disorder
The patient will corm a “C” and place it overall lateral hip.
A description of the pain will be deep interior hip pain!
Distribution of painful joints helps distinguish OA from other types of arthritis.
Unlikely locations for OA (unless traumatic injury)
MCO…wrist…elbow…ankle…shoulder
What hip pathologies present with morning stiffness?
Hip OA
Rheumatoid arthritis of the HIp is associated with mornig stiffness >1 hour
Avascular necrosis of the femoral head is associated with morning stiffness
What motion restrictions are common for HIP OA
Hip internal rotation and flexion are first motions to be restricted with hip OA
Significant decrease in motor function requires imaging to rule out an avulsion fracture and or nerve injury
How do you determine the mechanism of injury for the HIP?
Determine is the injury is the result of a traumatic event, overuse, or systemic cause.
What hip pathologies are most commonly caused by a traumatic event?
o Rule out fracture/dislocation
o Fall on outside of hip: bursitis or contusion with possible effect on abdominal/gluteal muscles
o Axial force through femur: articular cartilage damage, labral tear, pelvic fracture, hip subluxation
o Posterior blow to buttocks: sciatic nerve damage, gluteus maximus contusion
o Anterior blow to thigh: quadriceps contusion, myositis ossificans
o Acute muscle strains often occur following a short sprint, jump kick, fall, or collision.
What are typical overuse Hip Injuries
Femoral neck stress fractures in athletes or the nutritionally compromised
o ITB friction syndrome
o Muscle strains
o Bursitis
What are considered to be systemic hip pathologies?
RA Septic Arthritis Malignancy polymyalgia rheumatic lupus
Twinges of pain with weight bearing activity may indicate what?
Loose body within the joint
Consistent clicking at 45’ of flexion possibly caused by what?
Iliopsoas riding over the greater trochanter or anterior labrum,
If pain is associated with clicking what does that mean.
Further investigation is warranted
