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AT 500: Lower quadrant > Hip Injuries > Flashcards

Hip Injuries Flashcards

1
Q

Hip Flexor Strain (Presentation)

A
  • c/o “deep groin pain”
  • pain radiates to anterior hip or thigh
  • “limp” may occur
  • pain on deep palpation of Femoral Triangle
  • medial to sartorius muscle
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2
Q

Hip Flexor Strain (Provocative Manuvers)

A
  • extension of affected hip

- supine patient raises heels off table to 15 degrees

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3
Q

Differential Diagnosis for Hip Flexor Strain

A
  • iliopsoas bursa (between psoas muscle and femoral head
  • “Snapping Hip Syndrome”
  • Osteitis Pubis (athletic hernia)
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4
Q

Quadricepts Contusion Management

A
  • RICE and stretch

* * Initially avoid the use of any form of heat and massage

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5
Q

Myositis Ossificans

A
  • aberrant reparative process that causes benign heterotopic (extra skeletal) ossification in soft tissue
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6
Q

What are the two types of Myositis Ossificans

A
  1. Myositis ossificans circumscripta

2. Myositis ossificans progressiva (genetic, won’t ever see it)

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7
Q

Management of Myositis Ossificans

A
  • treated symptomatically
  • surgical removal is rare
  • put a pad over it
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8
Q

Proximal Hamstring Strain

A
  • can occur during an isolated athletic activity (acute) or result from persistent repetitive stress (chronic)
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9
Q

Risk factors that cause proximal hamstring strain

A
  • improper warm-up
  • fatigue
  • previous injury
  • strength imbalance
  • poor flexibility
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10
Q

Hip Adductor Strain (Groin)

A
  • most common musculoskeletal cause of groin pain in sports
  • muscule stretched or overloaded beyond normal range
  • muscles involved = adductor longs and gracilis
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11
Q

Differential Diagnosis for Hip Adductor Strain

A
  • sports hernia
  • osteitis pubis
  • femoral neck stress fracture
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12
Q

Management for Hip Adductor Strain

A
  • assess biomechanical causes
    • foot and lower leg mal- alignment
    • leg length discrepancy
    • gait abnormality
  • Muscular imbalance
  • Site, source and cause: shorter leg is more prone, pronates the foot
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13
Q

Management for a Chronic Hip Adductor strain

A
  • stretching program
  • low intensity isotonic exercise
  • consider active training exercise program
  • soft tissue management
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14
Q

“Snapping Hip”

A

A snapping sensation results from the movement of a muscle or tendon over a bony structure

  • most common site in hip is the lateral side where the IT band passes over the greater trochanter
  • or tendon of iliopsoas
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15
Q

Hip Pointer

A
  • injury to the iliac crest caused by a direct blow
  • the bone and overlying muscle can be bruised
  • in more serious cases, the hit can be so severe that a fracture of the bone results
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16
Q

Trochanteric Bursitis Possible Causes

A
  • repetitive stress (overuse) injuries
  • multiple minor traumatic injuries
  • leg length inequalities
  • excessive or prolonged pressure on the hip (standing too long)
  • an acute traumatic incident such as a fall
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17
Q

Signs and Symptoms of Trochanteric Bursitis

A
  • aching pain is usually focused on the outside of the upper thigh, just over the point of the hip
  • pain may radiate down the outside of the thigh as far as the knee
  • shorter leg more prone to bursitis
  • adductors are tight
  • feet are pronated
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18
Q

Iliopsoas Bursitis

A
  • inflammation of the bursa that separates the iliopsoas muscle from the underlying articular capsule of the hip
  • typically the result of “overuse”
19
Q

Ischial Bursitis

A
  • inflammation of bursa that separates the gluteus maximus muscle from the underlying bony prominence of the bone that we sit on, the ischial tuberosity
  • caused by prolonged sitting on hard surfaces
20
Q

Sciatica

A

Pain along the large sciatic nerve that runs from the lower back down the back of each leg

21
Q

Causes of Sciatica

A
  • degenerative disc disease (DDD)
  • HNP
  • Lumbar Spinal Stenosis
  • Spondylolisthesis
  • Piriformis Syndrome
22
Q

Presentation of Sciatica

A
  • pain in the rear or leg that is worse when sitting
  • weakness, numbness or difficulty moving the leg or foot
  • radiculopathy (tingling down the leg)
  • bowel/bladder issues
23
Q

Piriformis Syndrome

A
  • neuromuscular disorder that occurs when the piriformis muscle compresses or irritates the sciatic nerve
  • pain described as tingling or numbness in the buttocks and along the nerve
  • pain may worsen as a result of sitting for a long period of time, climbing stairs, walking or running
24
Q

Treatment for Piriformis Syndrome

A
  • stretching exercises
  • massage
    Activity modification
  • cessation of running, bicycling, or similar activities may be advised
25
Q

Hip Labral Tear

A
  • can be caused by repetitive motions (running/pivoting)

- or from traumatic cause (hip dislocation)

26
Q

Signs and Symptoms of Hip Labral Tear

A
  • catching or locking
  • limited ROM
  • Symptoms radiating into the groin
27
Q

Femoral Neck Fracture

A
  • 90% of hospitalizations for hip fractures are for people older than age 65
  • more common in females than males
28
Q

Presentation of Femoral Neck Fracture

A
  • severe pain in your hip or groin
  • inability to put weight on your injured leg
  • shorter leg on the side of your injured hip
  • may present with ER and slight abduction on the side of the injured hip
29
Q

Acute Management of Femoral Neck Fracture

A
  • Immediate immobilization: traction splint

- transport to hospital, typically treated with ORIF

30
Q

Femoral Neck Stress Fracture Symptoms

A
  • groin pain or anterior thigh pain
  • provoked by activity (weight bearing)
  • relieved with rest
31
Q

Femoral Neck Stress Fracture Signs

A
  • antalgic gait (trendelenburg gait)

- pain on internal hip rotation

32
Q

Osteitis Pubis

A
  • common cause chronic groin pain in athletes
  • caused by pregnancy
  • caused by vigorous weight bearing activity
33
Q

Pathophysiology of Osteitis Pubis

A

Pregnancy
- expanding pressure from growing fetus
Sports related repetitive stress injuries
- long distance running
- traction on pelvic musculature

34
Q

Predisposing factors in sports

A
  • limited internal hip rotation
  • sacroiliac joint fixation
  • lower limb biomechanics abnormalities
  • leg length discrepancy
  • over pronation
  • genu varum
  • genu valgum
35
Q

Signs for Osteitis Pubis

A
  • Tenderness to palpation of pubic symphysis
  • Provocative manuevers
    • active adduction (distal)
    • sit ups (proximal)
36
Q

Hip Dislocation

A
  • typical MOI involves a violent traumatic force such as MVA or fall from a height
  • 9/10 dislocations are posterior
37
Q

Presentation/Treatment for Hip Dislocation

A
  • very painful
  • possible nerve damage
  • may not have feeling in the foot
  • orthopedic emergency
  • call for help immediately
  • do NOT move injured person
38
Q

Ligamentus Teres Femoris

A
  • contain a small artery to the head of the femur
  • attaches to the margins of the ace tabular notch and transverse acetabular ligament and attached to the fovea/pit of femur
39
Q

Avascular Necrosis

A
  • disease resulting from temporary or permanent loss of the blood supply to the bones
  • can be caused by injury
40
Q

Presentation of Avascular necrosis

A
  • early stages could be asymptomatic

- most pt. experience joint pain only when weight bearing and then later on when resting

41
Q

Legg-Calve-Perthes Disease

A

osteonecrosis of the capital femoral epiphysis of the femoral head

42
Q

Characteristics of LCP Disease

A
  • caucasians are affected more frequently
  • males are affected 4-5 times more than females
  • most common in ages 3-12 years
  • congenital
43
Q

Slipped Capital Femoral Epiphysis

A

Refers to a fracture through the physics of the femoral head which results in slippage of the overlying end of the femur

44
Q

Slipped Capital Femoral Epiphysis - where it’s seen

A
  • mostly in boys between the ages of 10-17
  • characteristically tall and thin or obese
  • may occur bilaterally

AT 500: Lower quadrant (4 decks)

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