Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

DPT 616 : MSK > Hip Lecture > Flashcards

Hip Lecture Flashcards

1
Q

what are some potential causes of hip pain?

A

articular cartilage

childhood disorders (dysplasia, LCP, epiphysis)

inflammation (bursitis, tendonitis, synovitis)

infection

labral tears

neoplasm

neurologic (entrapment)

overuse (sprain, strain, hernia)

referred (disc, piriformis, SI, genitourinary)

systemic (RA, Chron’s, lupus, cancer)

trauma (fx, DL, avulsion, MO)

vascular (necrosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are some anterior hip/groin pathologies?

A

labral tears 2nd FAI

labral tears 2nd hypermobility

DJD/arthritis

femoral stress fx

SCFE

avascular necrosis

adductor strain

athletic pubalgia/sports hernia

avulsion fx of ASIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are some posterior hip pathologies?

A

referred pain from L spine, SI jt dysfxn

sciatic nerve entrapment

pudendal nerve entrapment

HS strain

ischiofemoral impingement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are some lateral hip pathologies?

A

external snapping hip

ITBS

glut med/min pathology

greater trochanter bursitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the 3 general MOI for pain and/or disability?

A

overuse situation

chronic degeneration

acute trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what things are a part of a pt’s PMH?

A

cardiac

surgery

meds

cancer

asthma

diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the components of the examination?

A

sensation

DTRs

AROM

PROM

accessory motion

MMTs

palpation

clinical tests

functional tasks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are radiographs used for?

A

fx

dislocations

arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are MRIs used for?

A

best choice for injuries to acetabular labrum and articular cartilage

femoroacetabular impingment

avascular necrosis of femoral head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are CTs used for?

A

to distinguish fx in the acetabulum

localizing position of fx fragments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are musculoskeletal USs used for?

A

primary choice to detect DDH in neonatal hips

guide aspiration procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are current s/s of hip pathology?

A

tasks that are challenging

snapping, catching, locking

magnitude of pain

location of pain (C-sign)

referral patterns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

t/f: leg length discrepancies always have a great impact on the treatment and pathology

A

false

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the clinical presentation of pediatric hip pathology?

A

assymetry of the thighs or gluteal folds

limitation of hip abd

unequal femoral length

abnormal gait pattern

(+) Ortolani test

(+) Barlow test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are abnormal gait patterns that may be seen in pediatric hip pathologies?

A

toe walking

in-toeing gait

out-toeing gait

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

t/f: the success of the Pavlik harness decreased in pts older than 4 months

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what does a Pavlik harness do?

A

holds the hip at 90-100 degrees of flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are some long term effects of DDH?

A

gait dysfxn

hip pain

DJD of hip

early onset THA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is avascular necrosis (Legg-Calve-Perthes Disease)?

A

damage to vascular supply that may occur at birth

trauma resulting in ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what % of avascular necrosis progresses to lead to collapse of the femoral head?

A

70-80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what population is avascular necrosis most common in?

A

boys aged 3-13 yo (average 5-7 yo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are the s/s of avascular necrosis (Legg-Calve-Perthes disease)?

A

pain in the groin, buttock, proximal thigh

pain exacerbated by weight bearing

decreased ROM

antalgic gait

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are some interventions for avascular necrosis (Legg-Calve-Perthes disease)?

A

emphasis on containment of the femoral head and avoiding collapse

Scottish Rite brace to hold the femur in abd w/the ability to flex

surgical intervention (hip resurfacing vs THA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is slipped capital femoral epiphysis (SCFE)?

A

the femoral head slips down and back off the femoral neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what is the initial symptom of 45% of pts with a SCFE?
knee or lower thigh pain
26
t/f: fx screening of a SCFE can manifest as a compression or tension rxn
true
27
if a pt with a SCFE has a compression rxn, what should be done?
reduce WB therapy
28
if a pt with a SCFE has a tension rxn, what should be done?
NWB often progresses to displacement and needs ORIF
29
what is the stress fx intervention for SCFE?
nutrition metabolic panal aquatics aerobic conditioning
30
what is the purpose of the patella-pubic percussion test?
to assess for osseous pathology
31
what is the position for the patella-pubic percussion test?
supine w/the stethoscope on the pubic symphysis
32
what is the technique of the patella-pubic percussion test?
percuss or vibrate tuning fork on the patella and compare BL to hear for difference in sound
33
what would be a positive result of the patella-pubic percussion test?
decreased sound transmission when compared BL
34
what are the stats for the patella-pubic percussion test?
sensitivity=excellent specificity=high-excellent
35
t/f: you should always ask WHERE the pain is when doing special tests
true
36
what is the purpose of the sign of the buttocks?
to assess for hip pathology, neoplasm, or abscess
37
what is the position for the sign of the buttocks?
supine
38
what is the technique for the sign of the buttocks?
performs passive SLR, note the angle of hip flexion that symptoms occur in flex the hip and knee and compare the angle of hip flexion that symptoms occur at w/the SLR angle
39
what is a (+) test for the sign of the buttocks?
hip flexion angle isn't greater than the SLR angle
40
what are the stats on the sign of the buttock?
no data
41
what is the purpose of the fulcrum test?
to assess for femoral shaft stress fxs
42
what is the position for the fulcrum test?
sitting, knees flexed, feet off the floor
43
what is the technique for the fulcrum test?
weave your arm under the involved femur to serve as a fulcrum apply a posterior force to the distal femur
44
what is a (+) fulcrum test?
sharp pain with force
45
what are the stats on the fulcrum test?
sensitivity=excellent specificity=high
46
t/f: we can always tell if the fall or the fx occurred first
false
47
t/f: the WB status of a pt depends on the type of fixation they have
true
48
what are some reasons for THA?
fx trauma dysplasia JRA and RA osteonecrosis malignancy
49
what factors can make a person a poor candidate for THA?
systemic co-morbidities gender vascular supply pre-op LEF score walking speed and TUG age weight dementia
50
with posterior approach THA, what muscles are involved?
violates the piriformis and short ER preserves the glut med and min
51
what are the concerns with posterior approach THA?
problem w/hip flexion causing DL
52
what muscles are involved in posterio-lateral THA?
splits the glut med
53
what are the concerns with the posterio-lateral approach THA?
lurching gait
54
what muscles are involved in the lateral approach THA?
splits glut med and ITB
55
what are the concerns with the lateral approach THA?
lurching gait
56
what muscles are involved in the anterio-lateral approach THA?
detaches 1/3 glut med
57
what are the concerns with the anterio-lateral approach THA?
takes longer and increased risk of HO
58
what muscles are involved in the anterior approach THA?
splits the ITB and sartorius
59
what are the concerns with the anterior approach THA?
takes longer and higher femur fx rate
60
what are the precautions with the posterior approach THA?
no flexion >90 degrees (trunk on LE and LE on trunk) no adduction past midline clients shouldn't sit in lower chairs for at least 6-8 weeks bc loads of 8x body weight can be produced at the hip jt when rising to stand
61
t/f: there is a reduced DL rate after hip arthroplasty for femoral neck fxs when changing from posteriolateral to anteriolateral approach
true
62
what are the risks of THA?
DL HO infection leg length discrepancies DVT
63
what are the 2 general categories of hip impingements?
femoroacetabular (FAI) - anterior ischiofemoral (IFI) - posterior
64
is an FAI anterior or posterior impingement?
anterior
65
is an IFI anterior or posterior impingement?
posterior
66
does anterior or posterior hip impingement cause asynchronous patterns of movement w/end range ER?
posterior impingement
67
painful palpation of the external rotators may point to what syndrome?
deep glut syndrome (sciatic/piriformis)
68
painful palpation of the ischial tuberosity may point it what syndrome?
ischial tunnel syndrome
69
what are the s/s of posterior hip impingement?
peripheral nerve entrapment syndrome of the sciatic nerve reproduction w/resisted ER reproduction w/FAdIR palpable MTrPs and/or hypertonic bands radiating neurologic symptoms w/any of the above maneuvers dull ache in buttocks that may radiate tenderness to the deep palpation (92%) pain with sitting (76%) and walking but decreased when in supine pain with resisted hip extension and passive IR/add
70
what is the active piriformis test?
in SL on the involved LE up in a clamshell position, palpate the piriformis and resist ER and abd
71
what is a (+) active piriformis test?
reproduction of pain
72
what is the seated piriformis stretch test?
seated with the knee extended, palpate about 1 cm lateral to the ischium and passively lower the leg into hip add and IR
73
what is a (+) seated piriformis stretch test?
pain with passive motion
74
what are the clustered metrics for the active piriformis and passive seated stretch tests?
sensitivity=91% specificity=80%
75
what is ischial tunnel syndrome?
thickening of the HS tendon posterior thigh pain aggravated by running
76
what are the clinical tests for ischial tunnel syndrome?
active 30/90 and long stride
77
what is the active 30/90 test?
in sitting flex the hip to 30 degrees then 90 degrees and palpate the conjoint tendon lateral or the ischial tuberosity and resist knee flexion for 5 seconds
78
what are the clustered metrics for the active 30/90 and long stride tests?
sensitivity=96% specificity=73% (+)LR=3.61 (-)LR=0.05
79
what is ischiofemoral impingement?
narrowing of the space bw the ischial tuberosity and lesser trochanter abnormalities of the quad fem ranging from deformity and edema to tears and atrophy hip pain radiating to the med thigh
80
IFI is most associated with what?
trauma or surgery
81
what is the IFI test?
with the pt in SL, passively extend the hip in neutral and/or add w/complaints of pain lateral to the ischium, repeat w/hip in abd
82
what is a (+) IFI test?
pain w/extension when the hip in in add that is relieved when the hip is in extension with abd
83
what are the stats for the IFI test?
sensitivity=82% (56-95%) specificity=85% (54-97%)
84
t/f: FAI (anterior) has a relationship to neonatal hip deviations
true
85
what is FAI caused by?
abnormal contact bw the femur and the acetabulum
86
what population tends to be more affected by FAI?
younger ppl who push the extremes of hip ROM esp with pivoting IR (10x risk) gymnastics, hockey, soccer, breast stroke
87
what is a cam lesion (FAI)?
osseous abnormality (bone bump) at the femoral head-neck junction abnormality of the femur impact damages articular cartilage
88
what is a pincer lesion (FAI)?
abnormality of the boney acetabulum leading to over coverage of the femoral head damage to the labrum
89
what is a mixed FAI lesion?
cam and pincer (femur and acetabulum bone bump)
90
what is the FAI presentation?
when asked where the hip hurts, client will cup their hip just above the greater trochanter (c-sign) groin pain w/FAdIR test sharp pain/clicking and giving away pain w/stair climbing and prolonged sitting difficulty with max squat or making cuts
91
what is the c-sign?
when asked where the hip hurts, the client with cup their hip just above the greater trochanter
92
what is the FAdIR test technique?
passive hip flexion, add, and IR
93
what is a (+) FAdIR test?
reproduction of pain
94
what are the stats for the FAdIR test?
sensitivity=excellent FAdIR + FAbER sensitivity=excellent FAdIR + FAbER + resisted SLR +Thomas test specificity=excellent
95
what is the impingement test positon?
supine 90/90
96
what is the impingement test technique?
passive IR, some clinicians recommend adding some axial compression and overpressure to IR
97
what is a (+) impingement test?
pain into the groin
98
what are the stats of the impingement test?
sensitivity=poor-excellent specificity=poor-high w/axial compression and IR overpressure sensitivity=high, specificity=poor
99
what is the maximal squat test used for?
detecting a cam lesion (FAI)
100
what is the maximal squat test technique?
perform a deep squat
101
what is a (+) maximal squat test?
pain limiting ability to complete the squat
102
what are the stats for the maximal squat test?
sensitivity=high specificity=poor
103
what is an intervention that is typically not helpful for FAI?
injections
104
what are some acute interventions for FAI?
3-5 days of cold application activity modification about 6 weeks NSAIDs
105
when inflammation decreased in FAI (about >5 days), what are some interventions?
stationary bike w/seat elevated stretch prn (piri, illiospoas, quads, ITB) strengthening prn (glut med, ER, and core musculature functional balance exercises begin w/1 leg activities and progress to sport specific exercises
106
if conservative therapy for FAI is unsuccessful, what may be done?
surgical ex correction of the abnormal shape of the femur (cam), acetabulum (pincer), or both mixed)
107
what are some interventions for immediate post-op debridement?
cryotherapy gentle ROM in mid-range post op bracing NWB-PWB w/crutches about 2-4 weeks

DPT 616 : MSK (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions